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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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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
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author 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
author_facet 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
author_sort Vancini-Campanharo, Cássia Regina
collection PubMed
description 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.
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spelling pubmed-58751522018-03-30 Do not attempt resuscitation orders at the emergency department of a teaching hospital 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 Einstein (Sao Paulo) Original Article 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. Instituto Israelita de Ensino e Pesquisa Albert Einstein 2017 /pmc/articles/PMC5875152/ /pubmed/29364362 http://dx.doi.org/10.1590/S1679-45082017AO3999 Text en https://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
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
Do not attempt resuscitation orders at the emergency department of a teaching hospital
title Do not attempt resuscitation orders at the emergency department of a teaching hospital
title_full Do not attempt resuscitation orders at the emergency department of a teaching hospital
title_fullStr Do not attempt resuscitation orders at the emergency department of a teaching hospital
title_full_unstemmed Do not attempt resuscitation orders at the emergency department of a teaching hospital
title_short Do not attempt resuscitation orders at the emergency department of a teaching hospital
title_sort do not attempt resuscitation orders at the emergency department of a teaching hospital
topic Original Article
url 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
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