Factors affecting do-not-attempt-resuscitation (DNAR) decisions among adult patients in the emergency department of a general tertiary teaching hospital in China: a retrospective observational study
Objective Do-not-attempt-resuscitation (DNAR) orders are designed to allow patients to opt out of receiving cardiopulmonary resuscitation in the event of a cardiac arrest. While DNAR has become a standard component of medical care, there is limited research available specifically focusing on DNAR or...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2023-10-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/13/10/e075714.full |
| _version_ | 1797639895822368768 |
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| author | Yang Liu Chao-Lan Wang Yu-Lei Gao Qing-Song Li Yan-Cun Liu Yan-Fen Chai |
| author_facet | Yang Liu Chao-Lan Wang Yu-Lei Gao Qing-Song Li Yan-Cun Liu Yan-Fen Chai |
| author_sort | Yang Liu |
| collection | DOAJ |
| description | Objective Do-not-attempt-resuscitation (DNAR) orders are designed to allow patients to opt out of receiving cardiopulmonary resuscitation in the event of a cardiac arrest. While DNAR has become a standard component of medical care, there is limited research available specifically focusing on DNAR orders in the context of emergency departments in China. This study aimed to fill that gap by examining the factors related to DNAR orders among patients in the emergency department of a general tertiary teaching hospital in China.Design Retrospective observational study.Setting Emergency department.Participants This study and analysis on adult patients with DNAR or no DNAR data between 1 January 2022 and 1 January 2023 in the emergency department of a large academic comprehensive tertiary teaching hospital. A total of 689 were included in our study.Primary outcome measures Whether the patient received DNAR was our dependent variable.Results Among the total patients, 365 individuals (53.0%) had DNAR orders. The following variables, including age, sex, age-adjusted Charlson comorbidity index (ACCI), primary diagnosis of cardiogenic or cancer related, history of neurological dysfunction or cancer, were independently associated with the difference between the DNAR group and the no DNAR group. Furthermore, there were significant statistical differences observed in the choice of DNAR among patients with different stages of cancer.Conclusions In comparison to the no DNAR group, patients with DNAR were characterised by being older, having a higher proportion of female patients, higher ACCI scores, a lower number of patients with a primary diagnosis of cardiogenic and a higher number of patients with a primary diagnosis of cancer related, history of neurological dysfunction or cancer. |
| first_indexed | 2024-03-11T13:24:06Z |
| format | Article |
| id | doaj.art-01965406a17f46f3ace27119aa03a334 |
| institution | Directory Open Access Journal |
| issn | 2044-6055 |
| language | English |
| last_indexed | 2024-03-11T13:24:06Z |
| publishDate | 2023-10-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj.art-01965406a17f46f3ace27119aa03a3342023-11-03T09:50:08ZengBMJ Publishing GroupBMJ Open2044-60552023-10-01131010.1136/bmjopen-2023-075714Factors affecting do-not-attempt-resuscitation (DNAR) decisions among adult patients in the emergency department of a general tertiary teaching hospital in China: a retrospective observational studyYang Liu0Chao-Lan Wang1Yu-Lei Gao2Qing-Song Li3Yan-Cun Liu4Yan-Fen Chai5Department of Emergency Medicine, Tianjin Medical University General Hospital, Tianjin, ChinaDepartment of Emergency Medicine, Tianjin Medical University General Hospital, Tianjin, ChinaDepartment of Emergency Medicine, Tianjin Medical University General Hospital, Tianjin, ChinaDepartment of Emergency Medicine, Tianjin Medical University General Hospital, Tianjin, ChinaDepartment of Emergency Medicine, Tianjin Medical University General Hospital, Tianjin, ChinaDepartment of Emergency Medicine, Tianjin Medical University General Hospital, Tianjin, ChinaObjective Do-not-attempt-resuscitation (DNAR) orders are designed to allow patients to opt out of receiving cardiopulmonary resuscitation in the event of a cardiac arrest. While DNAR has become a standard component of medical care, there is limited research available specifically focusing on DNAR orders in the context of emergency departments in China. This study aimed to fill that gap by examining the factors related to DNAR orders among patients in the emergency department of a general tertiary teaching hospital in China.Design Retrospective observational study.Setting Emergency department.Participants This study and analysis on adult patients with DNAR or no DNAR data between 1 January 2022 and 1 January 2023 in the emergency department of a large academic comprehensive tertiary teaching hospital. A total of 689 were included in our study.Primary outcome measures Whether the patient received DNAR was our dependent variable.Results Among the total patients, 365 individuals (53.0%) had DNAR orders. The following variables, including age, sex, age-adjusted Charlson comorbidity index (ACCI), primary diagnosis of cardiogenic or cancer related, history of neurological dysfunction or cancer, were independently associated with the difference between the DNAR group and the no DNAR group. Furthermore, there were significant statistical differences observed in the choice of DNAR among patients with different stages of cancer.Conclusions In comparison to the no DNAR group, patients with DNAR were characterised by being older, having a higher proportion of female patients, higher ACCI scores, a lower number of patients with a primary diagnosis of cardiogenic and a higher number of patients with a primary diagnosis of cancer related, history of neurological dysfunction or cancer.https://bmjopen.bmj.com/content/13/10/e075714.full |
| spellingShingle | Yang Liu Chao-Lan Wang Yu-Lei Gao Qing-Song Li Yan-Cun Liu Yan-Fen Chai Factors affecting do-not-attempt-resuscitation (DNAR) decisions among adult patients in the emergency department of a general tertiary teaching hospital in China: a retrospective observational study BMJ Open |
| title | Factors affecting do-not-attempt-resuscitation (DNAR) decisions among adult patients in the emergency department of a general tertiary teaching hospital in China: a retrospective observational study |
| title_full | Factors affecting do-not-attempt-resuscitation (DNAR) decisions among adult patients in the emergency department of a general tertiary teaching hospital in China: a retrospective observational study |
| title_fullStr | Factors affecting do-not-attempt-resuscitation (DNAR) decisions among adult patients in the emergency department of a general tertiary teaching hospital in China: a retrospective observational study |
| title_full_unstemmed | Factors affecting do-not-attempt-resuscitation (DNAR) decisions among adult patients in the emergency department of a general tertiary teaching hospital in China: a retrospective observational study |
| title_short | Factors affecting do-not-attempt-resuscitation (DNAR) decisions among adult patients in the emergency department of a general tertiary teaching hospital in China: a retrospective observational study |
| title_sort | factors affecting do not attempt resuscitation dnar decisions among adult patients in the emergency department of a general tertiary teaching hospital in china a retrospective observational study |
| url | https://bmjopen.bmj.com/content/13/10/e075714.full |
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