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Characteristics of patients who die in hospital with no attempt at resuscitation

Aune, Solveig, 1957 (author)
Gothenburg University,Göteborgs universitet,Hjärt-kärlinstitutionen,Cardiovascular Institute
Herlitz, Johan, 1949 (author)
Högskolan i Borås,Gothenburg University,Göteborgs universitet,Hjärt-kärlinstitutionen,Cardiovascular Institute,Akademin för vård, arbetsliv och välfärd,[external]
Bång, A (author)
Högskolan i Borås,Akademin för vård, arbetsliv och välfärd,[external]
 (creator_code:org_t)
Elsevier BV, 2005
English.
In: Resuscitation. - : Elsevier BV. - 0300-9572 .- 1873-1570. ; 65:3, s. 291-9
  • Journal article (peer-reviewed)
Abstract Subject headings
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  • OBJECTIVE: To describe the characteristics, cause of hospitalisation and symptoms prior to death in patients dying in hospital without resuscitation being started and the extent to which these decisions were documented. MATERIALS AND METHODS: All patients who died at Sahlgrenska University Hospital in Goteborg, Sweden, in whom cardiopulmonary resuscitation (CPR) was not attempted during a period of one year. RESULTS: Among 674 patients, 71% suffered respiratory insufficiency, 43% were unconscious and 32% had congestive heart failure during the 24h before death. In the vast majority of patients, the diagnosis on admission to hospital was the same as the primary cause of death. The cause of death was life-threatening organ failure, including malignancy (44%), cerebral lesion (10%) and acute coronary syndrome (10%). The prior decision of 'do not attempt resuscitation' (DNAR) was documented in the medical notes in 82%. In the remaining 119 patients (18%), only 16 died unexpectedly. In all these 16 cases, it was regarded retrospectively as ethically justifiable not to start CPR. CONCLUSION: In patients who died at a Swedish University Hospital, we did not find a single case in which it was regarded as unethical not to start CPR. The patient group studied here had a poor prognosis due to a severe deterioration in their condition. To support this, we also found a high degree of documentation of DNAR. The low rate of CPR attempts after in-hospital cardiac arrest appears to be justified.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Hälsovetenskap -- Hälso- och sjukvårdsorganisation, hälsopolitik och hälsoekonomi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Health Sciences -- Health Care Service and Management, Health Policy and Services and Health Economy (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Allmänmedicin (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- General Practice (hsv//eng)

Keyword

Adolescent
Adult
Aged
Aged
80 and over
Child
Female
Heart Arrest/epidemiology/*etiology/*therapy
Heart Failure
Congestive/complications
Hospitalization
Hospitals
University/statistics & numerical data
Humans
Kidney Failure/complications
Male
Middle Aged
Neoplasms/complications
Respiratory Insufficiency/complications
*Resuscitation Orders
Retrospective Studies
Sweden/epidemiology
Unconsciousness/complications

Publication and Content Type

ref (subject category)
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