Online Supplement

Quality of dying in the ICU: Is it worse for patients admitted from the hospital ward compared to those admitted from the emergency department?

Ann C. Long MD MS, Erin K. Kross MD, Ruth A. Engelberg PhD, Lois Downey MA, Elizabeth L. Nielsen MPH, Anthony L. Back MD, and J. Randall Curtis MD MPH

e-Figure 1. Cohort flow diagram

Power calculations for the FS-ICU and QODD-1 outcomes:

For multivariable linear regression, power can be estimated based upon the standard deviation of the predictor of interest, the variance inflation factor, and predicted residual standard errors from the regression model. Estimating a variance inflation factor of 1, we estimated > 80% power to detect a 1 point difference in the family QODD-1 and the nurse QODD-1 (two-tailed alpha = 0.05) and 80% power to detect a 5 point difference in the FS-ICU.

e-Table 1. Advance Care Planning by ICU Admission Source
Admission Source
Wards / ED
HOSPITAL ADMISSION CHARACTERISTICSa
Presence of a living will, n (%) / 211 (62) / 372 (56)
Presence of a DPOA, n (%) / 216 (75) / 398 (67)
DNR in place by end of hospital day 1, n (%) / 14 (3) / 248 (24)
  1. Information based upon available observations. Data regarding presence of a living will

missing for 32.5% of patients, designated power of attorney for 41.1% of patients, and

DNR orders for 1.0% of patients.

e-Table 2. Nurse Characteristicsa
N=380
Age at time of survey, mean (SD)b / 42.4 (10.1)
Sex, n (%)
Male / 52 (14)
Female / 327 (86)
Unknown / 1 (0)
Race/ethnicity, n (%)
White, non-Hispanic / 310 (82)
Hispanic or Non-white / 66 (17)
Unknown / 4 (1)
Years of critical care experience, mean (SD)c / 11.0 (9.2)
Surveys completed per nurse, median (IQR) / 1 (1-7)
  1. Surveys completed by 40.7% of nurses, 43.3% among nurses of patients

admitted from acute care and 39.5% for patients admitted from the ED. Some

nurses completed surveys for patients from the acute care floor and for patients

from the ED, thus nurse characteristics are not separated by admission source.

  1. Ages were reported by 376 of 380 nurses.
  2. Year of critical care experience reported by 378 of 380 nurses.