Abstract：
OBJECTIVE: Limitations of life sustaining therapies (LLST) are frequent in intensive care units (ICUs), but no previous studies have examined end-of-life (EOL) care and LLST in South Africa (SA).
METHODS: This study evaluated LLST in SA from the data of a prospective, international, multicentre, observational study (Ethicus-2) and compared practices with countries in the rest of the world.
RESULTS: LLST was relatively common in SA, and withholding was more frequent than withdrawing therapy. However, withdrawing and withholding therapy were less common, while failed CPR was more common, than in many other countries. No patients had an advance directive. Primary reasons for LLST in SA were poor quality of life, multisystem organ failure and patients\' unresponsiveness to maximal therapy. Primary considerations for EOL decision-making were good medical practice and patients\' best-interest, with the need for an ICU bed only rarely considered.
CONCLUSIONS: Withholding was more common than withdrawing treatment both in SA and worldwide, although both were significantly less frequent in SA compared with the world average.
METHODS: This study evaluated LLST in SA from the data of a prospective, international, multicentre, observational study (Ethicus-2) and compared practices with countries in the rest of the world.
RESULTS: LLST was relatively common in SA, and withholding was more frequent than withdrawing therapy. However, withdrawing and withholding therapy were less common, while failed CPR was more common, than in many other countries. No patients had an advance directive. Primary reasons for LLST in SA were poor quality of life, multisystem organ failure and patients\' unresponsiveness to maximal therapy. Primary considerations for EOL decision-making were good medical practice and patients\' best-interest, with the need for an ICU bed only rarely considered.
CONCLUSIONS: Withholding was more common than withdrawing treatment both in SA and worldwide, although both were significantly less frequent in SA compared with the world average.
摘要：
目的：在重症监护病房（ICU）中，维持生命疗法（LLST）的局限性很常见，但是以前没有研究检查南非（SA）的临终（EOL）护理和LLST。
方法：本研究从前瞻性，国际,多中心,观察性研究(Ethicus-2)，并与世界其他国家的实践进行比较。
结果：LLST在SA中相对常见，并且扣留比撤回治疗更频繁。然而,停药和停药治疗不太常见，虽然心肺复苏失败更常见，比其他许多国家都多。没有患者有预先指示。SA中LLST的主要原因是生活质量差，多系统器官衰竭和患者对最大治疗无反应。EOL决策的主要考虑因素是良好的医疗实践和患者的最佳利益，很少考虑需要ICU病床。
结论：在SA和全球范围内，扣留治疗比撤回治疗更常见，尽管与世界平均水平相比，两者在SA中的频率明显较低。
方法：本研究从前瞻性，国际,多中心,观察性研究(Ethicus-2)，并与世界其他国家的实践进行比较。
结果：LLST在SA中相对常见，并且扣留比撤回治疗更频繁。然而,停药和停药治疗不太常见，虽然心肺复苏失败更常见，比其他许多国家都多。没有患者有预先指示。SA中LLST的主要原因是生活质量差，多系统器官衰竭和患者对最大治疗无反应。EOL决策的主要考虑因素是良好的医疗实践和患者的最佳利益，很少考虑需要ICU病床。
结论：在SA和全球范围内，扣留治疗比撤回治疗更常见，尽管与世界平均水平相比，两者在SA中的频率明显较低。
