Kidney Week

Abstract: PUB314

Implementation of the "Life-Sustaining Treatment Decision-Making Act" in Decisions Regarding Dialysis: A 5-Year Single-Center Experience

Session Information

• Publication Only

Category: Geriatric Nephrology

• 1300 Geriatric Nephrology

Authors

• Hwang, Seokjin, Daejeon Eulji University Hospital, Daejeon, Daejeon, Korea (the Republic of)

Seokjin Hwang, MD

• Lee, Soyoung, Daejeon Eulji University Hospital, Daejeon, Daejeon, Korea (the Republic of)

Soyoung Lee, MD

• Lee, Sua, Daejeon Eulji University Hospital, Daejeon, Daejeon, Korea (the Republic of)

Sua Lee, MD

• Park, Bo Sun, Daejeon Eulji University Hospital, Daejeon, Daejeon, Korea (the Republic of)

Bo Sun Park, MD

Background

The legislation on life-sustaining treatment decisions was enacted in 2016 and has been in effect since February 2018 in South Korea due to social resistance to the implementation of life-sustaining treatment (LST) in patients with end-of-life care. Since then, patients at the end-of-life have been able to decide to receive or discontinue LST. These include cardiopulmonary resuscitation (CPR), mechanical ventilation (MV), hemodialysis (HD), and chemotherapy (CTX).

Methods

This was a retrospective chart review of patients who discontinued LST from August 2018 to May 2023 under the law on life-sustaining treatment decisions at single-center. We classified each patient based on underlying diseases, whether to implement existing LST, and whether to self-determine life-sustaining treatment.

Results

A total of 105 patients included in the study. Group 1 include patients previously had no dialysis treatment. Group 2 include patient with previous hemodialysis. This table shows the baseline characteristics of those patients (Table 1). The implementation of withdrawing LST was investigated for each group (Figure 1).

Conclusion

Our data shows the composition of patients’ implementation of LST termination decisions in a single center in Korea over 5 years. Comparing the dialysis and non-dialysis groups, there is a significant statistical difference in decision not to undergo MV (p=0.024). Patients’ decisions not to undergo CPR, HD, or CTX do not show a statistical difference between those two groups.