Higher Income Tied to Withdrawal of Life-Sustaining Therapies

WEDNESDAY, Jan. 24, 2024 (HealthDay News) -- Living in a high-income ZIP code increases the likelihood of withdrawal of life-sustaining therapies (WLSTs) for people with intracerebral hemorrhage (ICH), according to a study published online Jan. 18 in Neurology.

Kara R. Melmed, M.D., from NYU Langone Health in New York City, and colleagues examined differences in WLSTs and mortality in patients with ICH by neighborhood socioeconomic status. The analysis included retrospective data from 868 patients treated for ICH at one of three tertiary care hospitals from January 2017 to December 2022.

The researchers found that patients from ZIP codes with higher median household incomes had a higher incidence of WLST and mortality. There also was a significant association between Black non-Hispanic race and lower WLST and discharge mortality. When adjusting for age and clinical severity scores, patients who lived in ZIP codes with high income levels were more likely to have WLST (adjusted odds ratio, 1.88) and mortality before discharge (adjusted odds ratio, 1.5).

"Clinicians in future may need to tailor end-of-life care discussions, taking into account cultural and social factors when treating patients who have suffered an intracerebral hemorrhage and, in particular, with respect to withdrawing life support," senior author Jennifer A. Frontera, M.D., also from NYU Langone Health, said in a statement.

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