Prevalence of Patients With Do-Not-Resuscitate Status on Acute Geriatric Wards in Flanders, Belgium

Gendt, Cindy De; Bilsen, Johan; Noortgate, Nele Van Den; Lambert, Margareta; Stichele, Robert Vander; Deliens, Luc

doi:10.1093/gerona/62.4.395

Cited by 10 publications

(11 citation statements)

References 30 publications

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“…The frequency of DNACPR orders established within the 72 h after admission was 53%, which is higher than the data previously documented in the scientific literature (8.6-24% and even 40% in a nursing home) [6][7][8][12][13][14][15]. Only 39% of these decisions involved the patients and/or their relatives.…”

Section: Prevalence Of the Dnacprmentioning

confidence: 76%

“…Previous studies documented that the rate of DNACPR order among patients is variable: 8.6 to 24% for hospitalized patients [6][7][8][12][13][14][15] and up to 40% in nursing homes [16]. Several factors are associated with the DNACPR order: older age [7,12,16,17], presence of several comorbidities [12,[17][18][19], oncologic status [7,12,19], psychiatric disease [7], poor quality of life [7,17] and poor prognostic [7,17].…”

Section: Introductionmentioning

confidence: 99%

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Patients' characteristics associated with the decision of “do not attempt cardiopulmonary resuscitation” order in a Swiss hospital

Chevaux

Gagliano

Waeber

et al. 2015

European Journal of Internal Medicine

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Section: Prevalence Of the Dnacprmentioning

confidence: 76%

Section: Introductionmentioning

confidence: 99%

Patients' characteristics associated with the decision of “do not attempt cardiopulmonary resuscitation” order in a Swiss hospital

Chevaux

Gagliano

Waeber

et al. 2015

European Journal of Internal Medicine

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“…However, decisions to withdraw or withhold therapies frequently are taken too late in the discourse 135 of the disease of the older patient 29 . As a consequence, the clinical situation of the patients 136 sometimes does not allow communication.…”

Section: Old Versus Younger Patients 119mentioning

confidence: 99%

Factors influencing ICU referral at the end of life in the elderly

et al. 2010

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Remarks of the reviewers and answers of the authors: Could you please explain what a Belgian tertiary hospital is?We use the term 'tertiary' hospital as a synonym for a university hospital. This was adapted in the manuscript (in the abstract as well as in the method's section).Did the questionnaire you gave to the physicians also include questions why they decided to send the patients to the ICU or not?We agree that this would have been extremely valuable information. However, in order to have a maximum response rate, we used a very short questionnaire asking only objective data on the patient as well as on the DNR code and who participated in the decision to limit therapy.How was the decision made for a special DNR-Code? Was this decision mainly based on medical facts (prognosis underlying disease, comorbidity, functionality) or was this an overall decision with the participation of patient family, nurse and physician? Legal aspects in non-communicative patients -is there a legal representative who made the healthcare-decisions, or is that done by family members in Belgium?Legislation in Belgium demands that physicians inform and ask consent for every medical intervention/decision from the patient -or in case of incapacity from the surrogate decision-maker (this is in practice the nearest family).(this was added to the manuscript)The Order of Physicians in Belgium has added that it is also recommended to involve other members of the healthcare team (nurses!) in the DNR decision-making process.In this study, we see that 84% of competent patients were at least informed about the decision to limit therapy and that 100% of families of incompetent patients were informed. Only in 58%, nurses reported to be involved. (Table 1

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“…Gjennomgang av forskningslitteratur fra USA og Belgia viser at kun mellom 15,7-17 prosent av eldre pasienter blir spurt om sine preferanser om behandling ved livets slutt (1,2). I samsvar med disse funnene har en ny norsk studie (3) avdekket paternalistiske holdninger blant leger når det gjelder å velge den beste behandlingen av eldre pasienter i livets sluttfase på norske sykehjem.…”

Section: Paternalistiske Holdningerunclassified