دورية أكاديمية
Do-not-attempt-resuscitation decision making: physicians' recommendations differ from the GO-FAR score predictions.
| العنوان: | Do-not-attempt-resuscitation decision making: physicians' recommendations differ from the GO-FAR score predictions. |
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| المؤلفون: | Alao DO; Tawam Hospital, Al Ain, UAE. davidalao@uaeu.ac.ae.; Department of Internal Medicine, Section of Emergency Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, UAE. davidalao@uaeu.ac.ae., Abraham S; Tawam Hospital, Al Ain, UAE., Dababneh E; Life Support Center, Tawam Hospital, Al Ain, UAE., Roby R; Tawam Hospital, Al Ain, UAE., Farid M; Tawam Hospital, Al Ain, UAE., Mohammed N; Tawam Hospital, Al Ain, UAE., Rojas-Perilla N; Statistics Support Center, United Arab Emirates University, Al Ain, UAE., Cevik AA; Tawam Hospital, Al Ain, UAE.; Department of Internal Medicine, Section of Emergency Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, UAE. |
| المصدر: | International journal of emergency medicine [Int J Emerg Med] 2024 Jul 11; Vol. 17 (1), pp. 86. Date of Electronic Publication: 2024 Jul 11. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: BioMed Central Country of Publication: England NLM ID: 101469435 Publication Model: Electronic Cited Medium: Print ISSN: 1865-1372 (Print) Linking ISSN: 18651372 NLM ISO Abbreviation: Int J Emerg Med Subsets: PubMed not MEDLINE |
| أسماء مطبوعة: | Publication: [2018]- : [London, United Kingdom] : BioMed Central Original Publication: London : Springer, c2008-c2017. |
| مستخلص: | Background and Aim: In-hospital cardiac arrest (IHCA) is a major cause of mortality globally, and over 50% of the survivors will require institutional care as a result of poor neurological outcome. It is important that physicians discuss the likely outcome of resuscitation with patients and families during end-of-life discussions to help them with decisions about cardiopulmonary resuscitation. We aim to compare three consultants' do-not-resuscitate (DNR) decisions with the GO-FAR score predictions of the probability of survival with good neurological outcomes following in-hospital cardiac arrest (IHCA). Methods: This is a retrospective study of all patients 18 years or older placed on a DNR order by a consensus of three consultants in a tertiary institution in the United Arab Emirates over 12 months. Patients' socio-demographics and the GO-FAR variables were abstracted from the electronic medical records. We applied the GO-FAR score and the probability of survival with good neurological outcomes for each patient. Results: A total of 788 patients received a DNR order, with a median age of 71 years and a majority being males and expatriates. The GO-FAR model categorized 441 (56%) of the patients as having a low or very low probability of survival and 347 (44%) as average or above. There were 219 patients with a primary diagnosis of cancer, of whom 148 (67.6%) were in the average and above-average probability groups. There were more In-hospital deaths among patients in the average and above-average probability of survival group compared with those with very low and low probability (243 (70%) versus 249 (56.5%) (P < 0.0001)). The DNR patients with an average or above average chance of survival by GO-FAR score were more likely to be expatriates, oncology patients, and did not have sepsis. Conclusions: The GO-FAR score provides a guide for joint decision-making on the possible outcomes of CPR in the event of IHCA. The physicians' recommendation and the ultimate patient's resuscitation choice may differ due to more complex contextual medico-social factors. (© 2024. The Author(s).) |
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| فهرسة مساهمة: | Keywords: DNR; GO-FAR score; IHCA; Physician decision-making |
| تواريخ الأحداث: | Date Created: 20240711 Latest Revision: 20240714 |
| رمز التحديث: | 20240714 |
| مُعرف محوري في PubMed: | PMC11241957 |
| DOI: | 10.1186/s12245-024-00669-3 |
| PMID: | 38992598 |
| قاعدة البيانات: | MEDLINE |
Find this article in full text from Springer Verlag. 
Full Text Finder | تدمد: | 1865-1372 |
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| DOI: | 10.1186/s12245-024-00669-3 |