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Do not attempt resuscitation orders at the emergency department of a teaching hospital

OBJECTIVE: To identify factors associated with not attempting resuscitation. METHODS: A cross-sectional study conducted at the emergency department of a teaching hospital. The sample consisted of 285 patients; in that, 216 were submitted to cardiopulmonary resuscitation and 69 were not. The data wer...

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Detalles Bibliográficos
Autores principales: Vancini-Campanharo, Cássia Regina, Vancini, Rodrigo Luiz, Machado, Marcelo Calil, Lopes, Maria Carolina Barbosa Teixeira, Okuno, Meiry Fernanda Pinto, Batista, Ruth Ester Assayag, de Góis, Aécio Flávio Teixeira
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Instituto Israelita de Ensino e Pesquisa Albert Einstein 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5875152/
https://www.ncbi.nlm.nih.gov/pubmed/29364362
http://dx.doi.org/10.1590/S1679-45082017AO3999
Descripción
Sumario:OBJECTIVE: To identify factors associated with not attempting resuscitation. METHODS: A cross-sectional study conducted at the emergency department of a teaching hospital. The sample consisted of 285 patients; in that, 216 were submitted to cardiopulmonary resuscitation and 69 were not. The data were collected by means of the in-hospital Utstein Style. To compare resuscitation attempts with variables of interest we used the χ(2) test, likelihood ratio, Fisher exact test, and analysis of variance (p<0.05). RESULTS: No cardiopulmonary resuscitation was considered unjustifiable in 56.5% of cases; in that, 37.7% did not want resuscitation and 5.8% were found dead. Of all patients, 22.4% had suffered a previous cardiac arrest, 49.1% were independent for Activities of Daily Living, 89.8% had positive past medical/surgical history; 63.8% were conscious, 69.8% were breathing and 74.4% had a pulse upon admission. Most events (76.4%) happened at the hospital, the presumed cause was respiratory failure in 28.7% and, in 48.4%, electric activity without pulse was the initial rhythm. The most frequent cause of death was infection. The factors that influenced non-resuscitation were advanced age, history of neoplasm and the initial arrest rhythm was asystole. CONCLUSION: Advanced age, past history of neoplasia and asystole as initial rhythm were factors that significantly influenced the non-performance of resuscitation. Greater clarity when making the decision to resuscitate patients can positively affect the quality of life of survivors.