{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T23:18:32Z","timestamp":1790983112103,"version":"4.1.0"},"reference-count":24,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T00:00:00Z","timestamp":1771459200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/deed.de"},{"start":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T00:00:00Z","timestamp":1771459200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/deed.de"}],"funder":[{"name":"Deutscher Innovationsfond, Gemeinsamer Bundesausschuss","award":["01VSF19033"],"award-info":[{"award-number":["01VSF19033"]}]},{"DOI":"10.13039\/501100012681","name":"Universit\u00e4tsklinikum K\u00f6ln","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100012681","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Med Klin Intensivmed Notfmed"],"abstract":"<jats:title>Zusammenfassung<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Hintergrund<\/jats:title>\n                    <jats:p>Auf der Intensivstation liegt der Fokus typischerweise auf maximaler Therapie, Kuration und Lebensverl\u00e4ngerung. Das Einleiten von Therapieziel\u00e4nderungen (TZ\u00c4) zugunsten der Lebensqualit\u00e4t und eines w\u00fcrdevollen Sterbens stellt daher eine besondere Herausforderung dar.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ziel der Arbeit<\/jats:title>\n                    <jats:p>Analyse der Umsetzung von TZ\u00c4 auf einer kardiologischen Intensivstation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material und Methoden<\/jats:title>\n                    <jats:p>Retrospektive Aktenanalyse von 40\u00a0zuf\u00e4llig ausgew\u00e4hlten Patient:innen, die zwischen Juli 2019 und August 2021 auf der kardiologischen Intensivstation der Uniklinik K\u00f6ln verstarben. Deskriptive Statistik mithilfe der Software SPSS (IBM, Armonk, New York, USA)<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ergebnisse<\/jats:title>\n                    <jats:p>Die Patient:innen waren im Median 70,5 Jahre alt, verweilten im Median 4\u00a0Tage auf der Intensivstation und waren in 75\u202f% der F\u00e4lle m\u00e4nnlich. Die meisten Todesf\u00e4lle hatten kardiologische oder pneumologische Ursachen (30\/40). Eine TZ\u00c4 wurde bei 65\u202f% der Patient:innen dokumentiert; diese Gruppe war im Mittel \u00e4lter und hatte eine l\u00e4ngere Verweildauer. Die TZ\u00c4 erfolgte h\u00e4ufig erst in den letzten 24\u00a0Lebensstunden (81\u202f%). Entscheidungen wurden meist gemeinsam mit Angeh\u00f6rigen getroffen, da die Patient:innen h\u00e4ufig nicht mehr kommunikationsf\u00e4hig waren (85\u202f%). Es zeigte sich h\u00e4ufiger ein Verzicht auf Eskalation von Ma\u00dfnahmen als eine Deeskalation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Diskussion<\/jats:title>\n                    <jats:p>Die Ergebnisse zeigen 2\u00a0Patient:innengruppen mit unterschiedlichen Herausforderungen bei TZ\u00c4: 1)\u00a0Patient:innen mit pl\u00f6tzlichem Tod innerhalb von 72\u202fh, bei denen TZ\u00c4 selten m\u00f6glich ist, weshalb vor allem Resilienz im Umgang mit Sterbenden und Kommunikation mit Angeh\u00f6rigen entscheidend sind; 2)\u00a0Patient:innen mit l\u00e4ngeren Verweilzeiten, bei denen TZ\u00c4 h\u00e4ufiger umgesetzt werden. F\u00fcr diese Gruppe ist insbesondere die stetige Reevaluation der TZ\u00c4 und in diesem Zusammenhang der medizinischen Indikation und des Patient:innenwillens von besonderer Bedeutung.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00063-026-01415-8","type":"journal-article","created":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T12:56:47Z","timestamp":1771505807000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Therapieziel\u00e4nderung auf einer kardiologischen Intensivstation\u00a0\u2013 eine retrospektive Aktenanalyse","Change in goal-of-care in a\u00a0cardiological intensive care unit\u2014retrospective medical record analysis"],"prefix":"10.1007","author":[{"given":"Natalie","family":"Moormann","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Meesters","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sukhvir","family":"Kaur","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raymond","family":"Voltz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Adler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerstin","family":"Kremeike","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,2,19]]},"reference":[{"key":"1415_CR1","doi-asserted-by":"publisher","first-page":"125","DOI":"10.1007\/s00134-018-5461-9","volume":"45","author":"K Adler","year":"2019","unstructured":"Adler\u00a0K, Schlieper\u00a0D, Kindgen-Milles\u00a0D et\u00a0al (2019) Will your patient benefit from palliative care? 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R.\u00a0Voltz war zudem an der Erstellung der S3-Leitlinie Palliativmedizin beteiligt. K.\u00a0Kremeike erhielt au\u00dferdem eine F\u00f6rderung zur Open-access-Ver\u00f6ffentlichung im Rahmen des DEAL-Projekts. N.\u00a0Moormann und C.\u00a0Adler geben an, dass kein Interessenkonflikt besteht.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Interessenkonflikt"}},{"value":"Die Ethikkommission der Medizinischen Fakult\u00e4t der Universit\u00e4t zu K\u00f6ln erteilte der Studie am 19.04.2021 ein positives Votum (20-1727).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Interessenkonflikt"}}]}}