{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T14:35:24Z","timestamp":1787495724962,"version":"build-2736575974"},"reference-count":29,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T00:00:00Z","timestamp":1756425600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Hosp Palliat Care"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Muslim patients have historically received aggressive end-of-life care, though palliative acceptance is growing. The factors that influence ICU (aggressive) vs ward (comfort-focused) deaths remain unclear, limiting value-concordant care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To examine end-of-life care patterns and predictors of ICU vs ward death among Muslim patients, to guide culturally sensitive care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Retrospective cohort of adult Muslim decedents (2021-2024) at tertiary hospital in Muslim-majority country, stratified by death location: ward, ICU, and post-ICU ward. Multivariable logistic regression identified predictors of ward deaths.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      From fifty-thousand admissions, 1859 Muslim decedents were analyzed: ward (53%,\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 981), ICU (39%,\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 722), and post-ICU ward (8%,\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 156). Ward deaths involved older, comorbid patients, often with cancer (63%); ICU deaths were predominantly male with acute illnesses (29% sepsis). Post-ICU deaths showed intermediate profiles but highest tracheostomy rate (22%) and longest stays (48\u00a0days). ICU deaths had greatest life-sustaining interventions (82% mechanical ventilation), while ward deaths had highest palliative-care involvement (66%). Do-Not-Attempt-Resuscitation (DNAR) status rose from 20% on admission to 88% at death, with earliest transitions in ward deaths (median 3\u00a0days vs ICU: 15; post-ICU: 18). Ward deaths were independently associated with palliative care (aOR 15.11), code status discussion documentation (aOR 4.56), pre-existing terminal disease (aOR 2.98), cancer (aOR 1.61), and comorbidity burden (aOR 1.29), all\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .05.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Muslim ward deaths were associated with palliative involvement, prior terminal diagnoses, and earlier DNAR; while ICU\/post-ICU deaths reflected aggressive care with delayed transitions. DNAR adoption was high (88%) but late, underscoring the need for earlier, culturally aligned goals-of-care discussions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10499091251372627","type":"journal-article","created":{"date-parts":[[2025,8,30]],"date-time":"2025-08-30T06:17:39Z","timestamp":1756534659000},"page":"1098-1106","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["End-of-Life Trajectories Among Hospitalized Muslim Patients: Evolving from Aggressive to Comfort-Focused Care Across ICU, Post-ICU, and Ward Settings"],"prefix":"10.1177","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9901-926X","authenticated-orcid":false,"given":"Imran","family":"Khalid","sequence":"first","affiliation":[{"name":"King Faisal Specialist Hospital & Research Center"},{"name":"Alfaisal College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5314-8987","authenticated-orcid":false,"given":"Manahil","family":"Imran","sequence":"additional","affiliation":[{"name":"King Faisal Specialist Hospital & Research Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-2471-833X","authenticated-orcid":false,"given":"Raafey","family":"Imran","sequence":"additional","affiliation":[{"name":"King Faisal Specialist Hospital & Research Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2244-8397","authenticated-orcid":false,"given":"Muhammad Ali","family":"Akhtar","sequence":"additional","affiliation":[{"name":"Hurley Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8513-9025","authenticated-orcid":false,"given":"Maryam","family":"Imran","sequence":"additional","affiliation":[{"name":"King Faisal Specialist Hospital & Research Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Basel Ghurm","family":"Alshehri","sequence":"additional","affiliation":[{"name":"King Faisal Specialist Hospital & Research Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-9061-9916","authenticated-orcid":false,"given":"Ibrahim M.","family":"Imran","sequence":"additional","affiliation":[{"name":"King Faisal Specialist Hospital & Research Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anam","family":"Salman","sequence":"additional","affiliation":[{"name":"King Faisal Specialist Hospital & Research Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5998-7581","authenticated-orcid":false,"given":"Tabindeh Jabeen","family":"Khalid","sequence":"additional","affiliation":[{"name":"King Faisal Specialist Hospital & Research Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saqib","family":"Muhammad","sequence":"additional","affiliation":[{"name":"King Faisal Specialist Hospital & Research Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faisal","family":"Khateeb","sequence":"additional","affiliation":[{"name":"King Faisal Specialist Hospital & Research Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Syed S.","family":"Ali","sequence":"additional","affiliation":[{"name":"Yale University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,8,29]]},"reference":[{"key":"e_1_3_5_2_2","unstructured":"Pew Research Center. 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