An observational study in Family Members, Critical Illness and Frailty, sponsored by St George's, University of London. Recruiting at 1 site in United Kingdom. Open to participants aged 75 Years and older. Per ClinicalTrials.gov, last updated 2026-09-15.
Sponsored by St George's, University of London · Observational
The demographics of the global population is changing with increasing numbers of elderly and co-morbid patients. As a result, more elderly patients will be admitted to the Intensive Care Unit (ICU), which will bring several ethical challenges. It is for this reason the investigators have chosen to focus on this historically neglected and important patient population.
Little is known about how family meetings are implemented in ICUs in Europe and other parts of the world. However, these meetings contribute to building trust between the family and the ICU team. They are a crucial component for planning and conducting a time limited trials as they provide the opportunity for shared-decision making with the ICU team and with other stakeholders.
The investigators plan to determine the current practice of communication between ICU staff and patients and their relatives. The investigators expect to find a substantial variation in approaches to family meetings. This information may then help design and further investigate targeted interventions enabling shared decision-making focused on family and patient values.
The investigators research aim is to to investigate whether Family meetings are used in ICUs across Europe and other regions and, if so, how they are conducted and the influence on patient-centred outcome measures.
This is a prospective observational cohort study in patients aged 75 years old and above admitted as an emergency to the ICU and expected to have a length of stay of 3 days or more.
Consent varies between European countries. In some countries it will be taken on admission, in some (UK) it will be taken after the family meeting or on discharge from ICU and in others it has been waived.
Emergency patients admitted to the intensive care unit age 75 years and older. The investigators will ask participating ICUs to include the first consecutive 20 patients or all patients (if \<20) admitted within a 6 month period.
Exclusion Criteria:
The investigators will be looking at communication whilst these patients are on the Intensive Care Unit (ICU). In particular whether a family meeting takes place (to discuss progress and patient wishes) and if so what is discussed in the meeting. In addition to the information taken during the family meeting, the investigators will be collecting the following: baseline demographics, physiological data, frailty score and baseline function, treatments received and outcome data
Number of patients with a structured/planned family meeting
The number of patients that have a family meeting during the intensive care stay
Time frame: Until Intensive care unit (ICU) discharge
Median day since Intensive care unit (ICU) admission when the family meeting took place
Day number on ICU when family meeting took place
Time frame: Until ICU discharge
Number of people present in the Family Meeting
The total number of participants in the family meeting
Time frame: Until ICU discharge
Categorical description of people present in the Family Meeting
What were the roles of the participants in the family meeting (patient relatives, doctors, nurses, other health professionals.)
Time frame: Until ICU discharge
The treatment level after the family meeting
Treatment level category decided upon at the end of the family meeting which will be either: continuation of care, therapy reduced due to improvement, therapy withheld (WH), therapy withdrawn (WD).
Time frame: Until ICU discharge
Change in SOFA (Sequential Organ Failure Assessment) score between ICU admission and day of Family Meeting (FM)
Change in SOFA score from admission to the day of the family meeting. The SOFA score is a tool used to assess the severity of organ dysfunction in a critically ill patient. The total score ranges from 0-24, a higher SOFA score indicates a sicker patient and therefore a worse outcome
Time frame: Until ICU discharge
Survival until intensive care unit discharge
The number of patients that survive to Intensive care unit discharge
Time frame: ICU discharge
Intensive care unit (ICU) length of stay
The length of time the participant stays on intensive care (hours)
Time frame: ICU discharge
Hospital survival
The number of participants alive at hospital discharge
Time frame: From randomisation to hospital discharge, assessed up to 3 months
Hospital length of stay
The length of time the participant spends in hospital
Time frame: From randomisation to hospital discharge, assessed up to 3 months
Discharge location
Where patient is discharged to after discharge from hospital. Is it home, residential home, nursing home or other
Time frame: From randomisation to hospital discharge, assessed up to 3 months
Decision to limit life sustaining treatment
If there is a decision made to withdraw or with hold life sustaining treatment while the patient is on the intensive care unit. This is a yes / no answer
Time frame: Until ICU discharge
Time between limiting life sustaining treatment and death or ICU discharge
Time frame: From ICU admission until the first documented progression or date of death from any cause, whichever came first, assessed up to 30 days
Plan to share: Undecided
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St George's, University of London