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Timing of code status documentation and end-of-life outcomes in patients admitted to an oncology ward.
- Source :
-
Supportive Care in Cancer . Feb2014, Vol. 22 Issue 2, p375-381. 7p. - Publication Year :
- 2014
-
Abstract
- Purpose: Guidelines recommend documentation of care preferences for patients with advanced cancer upon hospital admission. We assessed end-of-life outcomes for patients who did or did not have code status (CS) documented within 48 h of admission. Methods: This was a retrospective cohort study of patients who died on an inpatient oncology ward between January 2004 and February 2009. Primary end-of-life outcomes were 'code blues' and cardiopulmonary resuscitation (CPR) attempts; secondary outcomes included unsuccessful CPR attempts, intensive care unit (ICU), consultations, and ICU admissions. Using logistic regression, outcomes were compared between those with and without CS documentation ≤48 h from admission (full code or do-not-resuscitate), controlling for significant confounders. Results: The 336 patients had a median age of 61 years; 97 % had advanced cancer. The median time from admission to death was 12 days (range <1-197 days); 151 patients (45 %) had CS documentation ≤48 h from admission. Controlling for confounders of reason for admission and marital status, patients with CS documentation ≤48 h from admission had fewer 'code blues' (2 vs. 15 %; adjusted odds ratio (AOR) 0.12, 95 % confidence interval (CI) 0.02-0.43), CPR attempts (1 vs. 11 %; AOR 0.12, 95 % CI 0.01-0.51), unsuccessful CPR attempts (0 vs. 11 %), ICU consultations (9 vs. 30 %; AOR 0.19, 95 % CI 0.08-0.40) and ICU admissions (2 vs. 5 %; AOR 0.18, 95 %CI 0.02-0.85). Conclusions: In patients who died on an oncology ward, CS documentation within 48 h of admission was associated with less aggressive end-of-life care, regardless of the reason for admission. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 09414355
- Volume :
- 22
- Issue :
- 2
- Database :
- Academic Search Index
- Journal :
- Supportive Care in Cancer
- Publication Type :
- Academic Journal
- Accession number :
- 93464149
- Full Text :
- https://doi.org/10.1007/s00520-013-1983-4