Do not attempt cardiopulmonary resuscitation (DNACPR) decisions for older medical inpatients: a cohort study.

IF 4.7 Q2 MATERIALS SCIENCE, BIOMATERIALS

ACS Applied Bio Materials Pub Date : 2024-12-19 DOI:10.1136/bmjspcare-2021-003084

Jane Walker, Katy Burke, Marta Wanat, Harriet Hobbs, Isabelle Rocroi, Michael Sharpe

{"title":"Do not attempt cardiopulmonary resuscitation (DNACPR) decisions for older medical inpatients: a cohort study.","authors":"Jane Walker, Katy Burke, Marta Wanat, Harriet Hobbs, Isabelle Rocroi, Michael Sharpe","doi":"10.1136/bmjspcare-2021-003084","DOIUrl":null,"url":null,"abstract":"Objectives: A decision not to attempt cardiopulmonary resuscitation in the event of cardiorespiratory arrest requires a discussion between the doctor and the patient and/or their relatives. We aimed to determine how many older patients admitted to acute medical wards had a pre-existing 'do not attempt cardiopulmonary resuscitation' (DNACPR) decision, how many had one recorded on the ward and how many of those who died had a DNACPR decision in place.Methods: A prospective cohort study, using data from medical records, of 481 consecutive patients aged ≥65 years admitted to the six acute medical wards of the John Radcliffe Hospital, Oxford.Results: 105/481 (22%) had a DNACPR decision at ward admission, 30 of which had been made in the emergency unit. A further 45 decisions were recorded on the ward, mostly after discussion with relatives. Of the 37 patients who died, 36 had a DNACPR decision. For the 20 deceased patients whose DNACPR decision was recorded during their admission, the median time from documentation to death was 4 days with 7/20 (35%) recorded the day before death.Conclusions: Older patients with multimorbidity need the opportunity to discuss the role of CPR earlier in their care and preferably before acute hospital admission.","PeriodicalId":2,"journal":{"name":"ACS Applied Bio Materials","volume":" ","pages":"e2461-e2464"},"PeriodicalIF":4.7000,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"ACS Applied Bio Materials","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1136/bmjspcare-2021-003084","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"MATERIALS SCIENCE, BIOMATERIALS","Score":null,"Total":0}

引用次数: 0

Abstract

Objectives: A decision not to attempt cardiopulmonary resuscitation in the event of cardiorespiratory arrest requires a discussion between the doctor and the patient and/or their relatives. We aimed to determine how many older patients admitted to acute medical wards had a pre-existing 'do not attempt cardiopulmonary resuscitation' (DNACPR) decision, how many had one recorded on the ward and how many of those who died had a DNACPR decision in place.

Methods: A prospective cohort study, using data from medical records, of 481 consecutive patients aged ≥65 years admitted to the six acute medical wards of the John Radcliffe Hospital, Oxford.

Results: 105/481 (22%) had a DNACPR decision at ward admission, 30 of which had been made in the emergency unit. A further 45 decisions were recorded on the ward, mostly after discussion with relatives. Of the 37 patients who died, 36 had a DNACPR decision. For the 20 deceased patients whose DNACPR decision was recorded during their admission, the median time from documentation to death was 4 days with 7/20 (35%) recorded the day before death.

Conclusions: Older patients with multimorbidity need the opportunity to discuss the role of CPR earlier in their care and preferably before acute hospital admission.

查看原文本刊更多论文

老年内科住院病人不尝试心肺复苏 (DNACPR) 的决定：一项队列研究。

目的：在心肺功能骤停时决定不尝试心肺复苏需要医生与患者和/或其亲属进行讨论。我们的目的是确定有多少入住急症病房的老年患者事先已做出 "不尝试心肺复苏"（DNACPR）的决定，有多少患者在病房内记录了这一决定，以及有多少死亡患者做出了 DNACPR 决定：方法：一项前瞻性队列研究，使用医疗记录中的数据，对牛津大学约翰-拉德克利夫医院六间急症病房连续收治的 481 名年龄≥65 岁的患者进行研究：结果：105/481（22%）名患者在入院时做出了 DNACPR 决定，其中 30 人是在急诊室做出的。另有 45 项决定是在病房记录的，大部分是在与亲属讨论后做出的。在 37 名死亡患者中，有 36 人做出了 DNACPR 决定。在入院时记录了DNACPR决定的20名死亡患者中，从记录到死亡的中位时间为4天，其中7/20（35%）是在死亡前一天记录的：结论：患有多种疾病的老年患者需要在护理过程中尽早讨论心肺复苏术的作用，最好是在急性入院之前。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

ACS Applied Bio Materials Chemistry-Chemistry (all)

CiteScore

9.40

自引率

2.10%

发文量

464

期刊介绍： ACS Applied Bio Materials is an interdisciplinary journal publishing original research covering all aspects of biomaterials and biointerfaces including and beyond the traditional biosensing, biomedical and therapeutic applications. The journal is devoted to reports of new and original experimental and theoretical research of an applied nature that integrates knowledge in the areas of materials, engineering, physics, bioscience, and chemistry into important bio applications. The journal is specifically interested in work that addresses the relationship between structure and function and assesses the stability and degradation of materials under relevant environmental and biological conditions.