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death and do-not-resuscitate order in the emergency department:A single-center three-year retrospective study in the Chinese mainland

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World Journal of Emergency Medicine 2020年第4期11卷 231-237页

作者： Chuan-qi Ding Yu-ping Zhang Yu-wei Wang Min-fei Yang Sa Wang Nian-qi Cui Jing-fen Jin Department of Nursing the Second Affi liated Hospital of Zhejiang University School of MedicineHangzhouChina Department of Emergency Medicine the Second Affi liated Hospital of Zhejiang University School of MedicineHangzhouChina

BACKGROUND:Consenting to do-not-resuscitate(DNR)orders is an important and complex medical decision-making process in the treatment of patients at the end-of-life in emergency departments(EDs).The DNR decision in EDs has not been extensively studied,especially in the Chinese ***:This retrospective chart study of all deceased patients in the ED of a university hospital was conducted from January 2017 to December *** patients with out-of-hospital cardiac arrest were ***:There were 214 patients’deaths in the ED in the three *** them,132 patients were included in this study,whereas 82 with out-of-hospital cardiac arrest were *** were 99(75.0%)patients’deaths after a DNR order medical decision,64(64.6%)patients signed the orders within 24 hours of the ED admission,68(68.7%)patients died within 24 hours after signing it,and 97(98.0%)patients had DNR signed by the family *** analysis showed that four independent factors infl uenced the family surrogates’decisions to sign the DNR orders:lack of referral(odds ratio[OR]0.157,95%confi dence interval[CI]0.047–0.529,P=0.003),ED length of stay(ED LOS)≥72 hours(OR 5.889,95%CI 1.290–26.885,P=0.022),acute myocardial infarction(AMI)(OR 0.017,95%CI 0.001–0.279,P=0.004),and tracheal intubation(OR 0.028,95%CI 0.007–0.120,Ppatients consenting for DNR order is lower than that of developed *** decision to sign DNR orders is mainly affected by referral,ED LOS,AMI,and trachea intubation.

关键词： Emergency service Do-not-resuscitate death patients Retrospective analysis Emergency departments

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