Determinant factors of mortality in terminally ill patients with do-not-resuscitate orders

Background: This study aimed to profile the clinical pictures and identify the risk factors of mortality among terminally ill patients who visited the emergency department (ED) and had signed do-not-resuscitate (DNR) consents. Methods: This prospective study employed purposeful sampling of 200 adult...

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Bibliographic Details
Main Authors: Chao-Hui Su, Shih-Chiang Hung, Wan-I Chen, Li-Hui Yang, Chi-Wei Lee, Ching-Hua Hsieh
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2018-01-01
Series:Formosan Journal of Surgery
Subjects:
Online Access:http://www.e-fjs.org/article.asp?issn=1682-606X;year=2018;volume=51;issue=6;spage=213;epage=218;aulast=Su
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Summary:Background: This study aimed to profile the clinical pictures and identify the risk factors of mortality among terminally ill patients who visited the emergency department (ED) and had signed do-not-resuscitate (DNR) consents. Methods: This prospective study employed purposeful sampling of 200 adult, nontrauma, terminally ill patients who visited the ED and signed a DNR consent between July 1, 2011, and March 31, 2012. Physiological variables were compared between fatal and survival patients using Student's t-tests after assessing the normality of the data distribution. Results: The Cox proportional regression analysis revealed that patients taking antiarrhythmic drugs and vasopressor had a 47.6-fold and 2.8-fold higher mortality, respectively, compared to nonusers and those who had a respiratory rate ≥28 breaths/min showed a 2.8-fold increase in their risk of death compared to those with a respiratory rate <28 breaths/min. Conclusions: Among terminally ill patients who had signed a DNR consent at the ED, significantly higher hazard ratios of mortality were observed in patients who were on antiarrhythmic drugs or vasopressor, had respiratory rates ≥28 breaths/min, had been intubated, and had serum potassium levels ≥ 4.5 mEq/L.
ISSN:1682-606X