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Factors associated with the decision to terminate resuscitation early for adult in-hospital cardiac arrest: Influence of family in an East Asian society

BACKGROUND: We attempted to identify factors associated with physicians’ decisions to terminate CPR and to explore the role of family in the decision-making process. METHODS: We conducted a retrospective observational study in a single center in Taiwan. Patients who experienced in-hospital cardiac a...

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Autores principales: Wang, Chih-Hung, Chang, Wei-Tien, Huang, Chien-Hua, Tsai, Min-Shan, Yu, Ping-Hsun, Wu, Yen-Wen, Chen, Wen-Jone
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6405092/
https://www.ncbi.nlm.nih.gov/pubmed/30845157
http://dx.doi.org/10.1371/journal.pone.0213168
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author Wang, Chih-Hung
Chang, Wei-Tien
Huang, Chien-Hua
Tsai, Min-Shan
Yu, Ping-Hsun
Wu, Yen-Wen
Chen, Wen-Jone
author_facet Wang, Chih-Hung
Chang, Wei-Tien
Huang, Chien-Hua
Tsai, Min-Shan
Yu, Ping-Hsun
Wu, Yen-Wen
Chen, Wen-Jone
author_sort Wang, Chih-Hung
collection PubMed
description BACKGROUND: We attempted to identify factors associated with physicians’ decisions to terminate CPR and to explore the role of family in the decision-making process. METHODS: We conducted a retrospective observational study in a single center in Taiwan. Patients who experienced in-hospital cardiac arrest (IHCA) between 2006 and 2014 were screened for study inclusion. Multivariate survival analysis was conducted to identify independent variables associated with IHCA outcomes using the Cox proportional hazards model. RESULTS: A total of 1525 patients were included in the study. Family was present at the beginning of CPR during 722 (47.3%) resuscitation events. The median CPR duration was significantly shorter for patients with family present at the beginning of CPR than for those without family present (23.5 mins vs 30 min, p = 0.01). Some factors were associated with shorter time to termination of CPR, including arrest in an intensive care unit, Charlson comorbidity index score greater than 2, age older than 79 years, baseline evidence of motor, cognitive, or functional deficits, and vasopressors in place at time of arrest. After adjusting for confounding effects, family presence was associated with shorter time to termination of CPR (hazard ratio, 1.25; 95% confidence interval, 1.06–1.46; p = 0.008). CONCLUSION: Clinicians’ decisions concerning when to terminate CPR seemed to be based on outcome prognosticators. Family presence at the beginning of CPR was associated with shorter duration of CPR. Effective communication, along with outcome prediction tools, may avoid prolonged CPR efforts in an East Asian society.
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spelling pubmed-64050922019-03-17 Factors associated with the decision to terminate resuscitation early for adult in-hospital cardiac arrest: Influence of family in an East Asian society Wang, Chih-Hung Chang, Wei-Tien Huang, Chien-Hua Tsai, Min-Shan Yu, Ping-Hsun Wu, Yen-Wen Chen, Wen-Jone PLoS One Research Article BACKGROUND: We attempted to identify factors associated with physicians’ decisions to terminate CPR and to explore the role of family in the decision-making process. METHODS: We conducted a retrospective observational study in a single center in Taiwan. Patients who experienced in-hospital cardiac arrest (IHCA) between 2006 and 2014 were screened for study inclusion. Multivariate survival analysis was conducted to identify independent variables associated with IHCA outcomes using the Cox proportional hazards model. RESULTS: A total of 1525 patients were included in the study. Family was present at the beginning of CPR during 722 (47.3%) resuscitation events. The median CPR duration was significantly shorter for patients with family present at the beginning of CPR than for those without family present (23.5 mins vs 30 min, p = 0.01). Some factors were associated with shorter time to termination of CPR, including arrest in an intensive care unit, Charlson comorbidity index score greater than 2, age older than 79 years, baseline evidence of motor, cognitive, or functional deficits, and vasopressors in place at time of arrest. After adjusting for confounding effects, family presence was associated with shorter time to termination of CPR (hazard ratio, 1.25; 95% confidence interval, 1.06–1.46; p = 0.008). CONCLUSION: Clinicians’ decisions concerning when to terminate CPR seemed to be based on outcome prognosticators. Family presence at the beginning of CPR was associated with shorter duration of CPR. Effective communication, along with outcome prediction tools, may avoid prolonged CPR efforts in an East Asian society. Public Library of Science 2019-03-07 /pmc/articles/PMC6405092/ /pubmed/30845157 http://dx.doi.org/10.1371/journal.pone.0213168 Text en © 2019 Wang et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Wang, Chih-Hung
Chang, Wei-Tien
Huang, Chien-Hua
Tsai, Min-Shan
Yu, Ping-Hsun
Wu, Yen-Wen
Chen, Wen-Jone
Factors associated with the decision to terminate resuscitation early for adult in-hospital cardiac arrest: Influence of family in an East Asian society
title Factors associated with the decision to terminate resuscitation early for adult in-hospital cardiac arrest: Influence of family in an East Asian society
title_full Factors associated with the decision to terminate resuscitation early for adult in-hospital cardiac arrest: Influence of family in an East Asian society
title_fullStr Factors associated with the decision to terminate resuscitation early for adult in-hospital cardiac arrest: Influence of family in an East Asian society
title_full_unstemmed Factors associated with the decision to terminate resuscitation early for adult in-hospital cardiac arrest: Influence of family in an East Asian society
title_short Factors associated with the decision to terminate resuscitation early for adult in-hospital cardiac arrest: Influence of family in an East Asian society
title_sort factors associated with the decision to terminate resuscitation early for adult in-hospital cardiac arrest: influence of family in an east asian society
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6405092/
https://www.ncbi.nlm.nih.gov/pubmed/30845157
http://dx.doi.org/10.1371/journal.pone.0213168
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