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Futility in TAVI: A scoping review of definitions, predictive criteria, and medical predictive models.
PLoS One
January 2025
Department of Cardiology, University & Hospital Fribourg, Fribourg, Switzerland.
Background: Transcatheter Aortic Valve Implantation (TAVI) procedures are rapidly expanding, necessitating a more extensive stratification of patients with aortic stenosis. Especially in the high-risk group, some patients fail to derive optimal or any benefits from TAVI, leading to the risk of futile interventions. Despite consensus among several experts regarding the importance of recognizing and anticipating such interventions, the definition, and predictive criteria for futility in TAVI remain ambiguous.
View Article and Find Full Text PDFHigh-risk percutaneous coronary intervention in patients with reduced left ventricular ejection fraction deemed not suitable for surgical revascularisation. A clinical consensus statement from the European Association of Percutaneous Cardiovascular Interventions (EAPCI) in collaboration with the ESC Working Group on Cardiovascular Surgery.
EuroIntervention
January 2025
Department of Cardiac-Thoracic-Vascular Sciences, University of Padua, Padua, Italy.
This clinical consensus statement of the European Association of Percutaneous Cardiovascular Interventions was developed in association with the European Society of Cardiology Working Group on Cardiovascular Surgery. It aims to define procedural and contemporary technical requirements that may improve the efficacy and safety of percutaneous coronary intervention (PCI), both in the acute phase and at long-term follow-up, in a high-risk cohort of patients on optimal medical therapy when clinical and anatomical high-risk criteria are present that entail unacceptable surgical risks, precluding the feasibility of coronary artery bypass grafting (CABG). This document pertains to patients with surgical contraindication according to the Heart Team, in whom medical therapy has failed (e.
View Article and Find Full Text PDFThe inability to predict futility in hemorrhaging trauma patients using 4-hour transfusion volumes and rates.
J Trauma Acute Care Surg
January 2025
From the Department of Surgery (J.-M.V., T.W.C., B.A.C.), McGovern Medical School, University of Texas Health Science Center, Houston, Texas; Department of Epidemiology (B.L.R.-R., S.R.W.) and Department of Surgery (J.W.C.), University of Pennsylvania, Philadelphia, Pennsylvania; Donald D. Trunkey Center for Civilian and Combat Casualty Care (M.A.S.), Oregon Health & Science University, Portland, Oregon; Department of Surgery, Ernest E. Moore Shock Trauma Center at Denver Health (E.E.M.), University of Colorado Health Sciences Center, Denver, Colorado; Department of Surgery (N.N.), University of Miami/Jackson Memorial Hospital, Miami, Florida; and Department of Surgery (J.L.S.), Trauma and Transfusion Medicine Research Center, University of Pittsburgh, Pittsburgh, Pennsylvania.
Background: Blood shortages and utilization stewardship have motivated the trauma community to evaluate futility cutoffs during massive transfusions (MTs). Recent single-center studies have confirmed meaningful survival in ultra-MT (≥20 U) and super-MT (≥50 U), while others advocate for earlier futility cut points. We sought to evaluate whether transfusion volume and intensity cut points could predict 100% mortality in a multicenter analysis.
View Article and Find Full Text PDFVeterinary technicians report in a survey how futile veterinary treatments contribute to their moral distress and impact their professional and personal lives.
J Am Vet Med Assoc
January 2025
3Center for Bioethics, Harvard Medical School, Harvard University, Boston, MA.
Objective: To document veterinary technicians' (VTs') experiences with medical futility and its subsequent impact on moral distress and attrition from the profession.
Methods: A cross-sectional study using a 56-question web-based, confidential and anonymous survey was distributed through the National Association of Veterinary Technicians in America between January 19 and February 15, 2023.
Results: There were 1,944 responses from approximately 8,500 members (22% response rate).
Futile care in COVID-19: how ICU nurses' resilience impacts turnover intention? A cross-sectional descriptive study.
BMC Health Serv Res
December 2024
Department of Public Health, School of Allied Medical Sciences, Maragheh University of Medical Sciences, Maragheh, Iran.
Background: Futile care is a set of actions without creating a reasonable chance of benefiting critically ill patients. In the COVID-19 pandemic, there is a need to discuss futile care perception. This may cause unbearable pressure for nurses in terms of resilience and turnover intention.
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