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Prevalence and related factors of do-not-resuscitate orders among in-hospital cardiac arrest patients

Tangxing Jiang1, Yanyan Ma1, Jiaqi Zheng1

  • 1Department of Emergency Medicine, Qilu Hospital of Shandong University, Jinan, China; Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, Institute of Emergency and Critical Care Medicine of Shandong University, Qilu Hospital of Shandong University, Jinan, China; Key Laboratory of Emergency and Critical Care Medicine of Shandong Province, Key Laboratory of Cardiopulmonary-Cerebral Resuscitation Research of Shandong Province, Shandong Provincial Engineering Laboratory for Emergency and Critical Care Medicine, Qilu Hospital of Shandong University, Jinan, China; The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese Ministry of Health and Chinese Academy of Medical Sciences; The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine; Qilu Hospital of Shandong University, Jinan, China.

Heart & Lung : the Journal of Critical Care
|November 3, 2021
PubMed

Insights

The do-not-resuscitate (DNR) order signing rate is low in mainland China. Factors like older age, female sex, and certain medical conditions influence DNR establishment among in-hospital cardiac arrest patients.

Area of Science:

  • Medical Ethics
  • Critical Care Medicine
  • Public Health

Background:

  • Studies on do-not-resuscitate (DNR) orders in mainland China are limited.
  • Understanding DNR prevalence and influencing factors is crucial for end-of-life care planning.

Purpose of the Study:

  • To explore the prevalence and associated factors of DNR orders in patients experiencing in-hospital cardiac arrest (IHCA) in mainland China.
  • To provide insights into DNR decision-making within a tertiary hospital setting.

Main Methods:

  • Retrospective analysis of 1154 IHCA patients from July 2019 to September 2020.
  • Data collection on DNR status from medical records.
  • Logistic regression analysis to identify factors associated with DNR order establishment.

Main Results:

  • 46.4% of IHCA patients had DNR orders.
  • Factors associated with higher DNR rates included female sex, older age, local residency, pulmonary infection, respiratory insufficiency, shock, acute stroke, neurological dysfunction, and cancer.
  • New-onset coronary artery disease was associated with a lower likelihood of DNR orders.

Conclusions:

  • The rate of DNR order signing in mainland China is low.
  • Demographic characteristics and comorbidities significantly influence the establishment of DNR orders among IHCA patients.
Abstract

Keywords:
Do not resuscitateIn-hospital cardiac arrestPrevalenceRelated factors

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