Do not attempt resuscitation order in Japan

Inokuchi, Sadaki; Kobayashi, Nobuo; Ohkubo, Yoshinobu

doi:10.1002/ams2.271

Cited by 10 publications

(7 citation statements)

References 20 publications

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“…4 There are no universally accepted protocols, laws, or evidence-based guidelines in regard to the procedure of ascertaining do not attempt cardiopulmonary resuscitation (DNACPR) in Japan. 5 Commonly, DNACPR is provided by the patient to the treating physician, sometimes with an aid of other healthcare personnel such as nurses, and it can also be given by the family member, but there is no standard process accepted to all for the reason described above. Therefore, when acutely ill patients are hospitalized, early decision-making regarding whether or not to have DNACPR order can be difficult.…”

Section: Introductionmentioning

confidence: 99%

The Vicissitude of Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) Order During COVID-19 Pandemic in Japan – A Retrospective Cohort Study

Morishita¹,

Iwata²

2022

IJGM

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Japan went through five surges of coronavirus disease 2019 or "waves". However, their impacts on the do not attempt cardiopulmonary resuscitation (DNACPR) of the patients are not known. Methods: A retrospective single-center cohort study was conducted for all hospitalized patients with COVID-19 from March 1, 2020, to September 30, 2021. Their code status was retrieved, and its association with the waves and other parameters, such as in-hospital mortality, was investigated. The relationship between DNACPR status and each wave was examined, as well as the effect on inhospital mortality. Results: A total of 1153 patients were hospitalized with the diagnosis of COVID-19 during the study period. On admission, 117 patients (10.1%) had DNACPR orders, 373 patients (32.4%) were on full code, 45 patients (3.9%) stated that they cannot decide code status. DNACPR rate appeared to increase at the summit of each wave. Subsequently, 160 patients (13.9%) became DNACPR status, 385 patients (33.4%) became full code, and 12 patients (1.0%) stated that they remained unable to decide code status. There was no association between DNACPR status and each wave, and DNACPR status was not associated with higher mortality (P = 0.87), both by logistic regression analysis. Conclusion: DNACPR status among hospitalized COVID-19 patients appeared to have changed over multiple waves in Japan, but it is more likely due to the change of the patients' demographics, particularly their age. DNACPR was common among the elderly, but it was not independently associated with higher mortality.

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Section: Introductionmentioning

confidence: 99%

The Vicissitude of Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) Order During COVID-19 Pandemic in Japan – A Retrospective Cohort Study

Morishita¹,

Iwata²

2022

IJGM

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“…Consequently, DNAR causes confusion between paramedics and family members, and instructions from physicians are necessary during emergency in Japan. 13 Nakagawa et al 14 reported that most hospitals have experienced patients with DNARs, yet not many hospitals have a guideline for DNARs. When patients with DNARs go into CPA at their home, it is unclear whether CPR should be performed.…”

Section: Discussionmentioning

confidence: 99%

Realizing the Wishes of Terminal Patients: Caregiving Transport Efforts for End of Life in the Kuji Area of Japan

Yaegashi

Otsuka

Nitta

et al. 2021

Palliative Medicine Reports

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“…Afterwards, the ideal way of language should be determined for community norms to share DNAR with patients/relatives. The most important determinants in DNAR decision are found to be prognosis of the disease and expected life quality (12). The most DNAR requests belong to malignant tumors, dementia, cerebrovascular disease sequels (13).…”

Section: Discussionmentioning

confidence: 99%

Applicability of the Concept of ‘Do Not Attempt Resuscitation’ in the Emergency Department

Şener¹,

ph²,

Unluer³

2021

Preprint

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Introduction : The issue of Do Not Attempt Resuscitation (DNAR), which is still being debated all over the world, is extremely complex and has not yet been discussed extensively in our country. Our aim in this study; to determine the place of DNAR in emergency services and the applicability of DNAR concept. Materials and Methods: This study was designed as a cross-sectional survey in Turkey. The questions were designed to examine physicians’ approaches to the concept of DNAR, whether they apply this concept and why. Results: A total of 246 physicians were reached. Sixty-nine physicians (30%) stated that they used DNAR in practice and metastatic terminal stage malignancy patients were found to be the most accepted DNAR group. There was a statistically significant difference between physicians’ anxiety about physical violence. Discussion: In order to increase the quality of CPR, patients should be well analyzed. The applicability of the concept of DNAR in our country is not legally possible. However, this situation does not prevent the emergence of patients who will not benefit from treatment in the clinic. Conclusion: It is best to establish a committee on DNAR and redefine the legal rules within certain norms.

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Do not attempt resuscitation order in Japan

Cited by 10 publications

References 20 publications

The Vicissitude of Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) Order During COVID-19 Pandemic in Japan – A Retrospective Cohort Study

The Vicissitude of Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) Order During COVID-19 Pandemic in Japan – A Retrospective Cohort Study

Realizing the Wishes of Terminal Patients: Caregiving Transport Efforts for End of Life in the Kuji Area of Japan

Applicability of the Concept of ‘Do Not Attempt Resuscitation’ in the Emergency Department

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