Do not attempt resuscitation orders at the emergency department of a teaching hospital

Author:

Vancini-Campanharo Cássia Regina1,Vancini Rodrigo Luiz2,Machado Netto Marcelo Calil3,Lopes Maria Carolina Barbosa Teixeira1,Okuno Meiry Fernanda Pinto1,Batista Ruth Ester Assayag1,Góis Aécio Flávio Teixeira de1

Affiliation:

1. Universidade Federal de São Paulo, Brazil

2. Universidade Federal do Espírito Santo, Brazil

3. Hospital Nipo-Brasileiro, Brazil

Abstract

ABSTRACT Objective: To identify factors associated with not attempting resuscitation. Methods: A cross-sectional study conducted at the emergency department of a teaching hospital. The sample consisted of 285 patients; in that, 216 were submitted to cardiopulmonary resuscitation and 69 were not. The data were collected by means of the in-hospital Utstein Style. To compare resuscitation attempts with variables of interest we used the χ2 test, likelihood ratio, Fisher exact test, and analysis of variance (p<0.05). Results: No cardiopulmonary resuscitation was considered unjustifiable in 56.5% of cases; in that, 37.7% did not want resuscitation and 5.8% were found dead. Of all patients, 22.4% had suffered a previous cardiac arrest, 49.1% were independent for Activities of Daily Living, 89.8% had positive past medical/surgical history; 63.8% were conscious, 69.8% were breathing and 74.4% had a pulse upon admission. Most events (76.4%) happened at the hospital, the presumed cause was respiratory failure in 28.7% and, in 48.4%, electric activity without pulse was the initial rhythm. The most frequent cause of death was infection. The factors that influenced non-resuscitation were advanced age, history of neoplasm and the initial arrest rhythm was asystole. Conclusion: Advanced age, past history of neoplasia and asystole as initial rhythm were factors that significantly influenced the non-performance of resuscitation. Greater clarity when making the decision to resuscitate patients can positively affect the quality of life of survivors.

Publisher

FapUNIFESP (SciELO)

Subject

General Medicine

Reference16 articles.

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