Evidence map›Paper›PMID 26496311›Full record

Observational studyMedicine2015

The Outcome of Patients With 2 Different Protocols of Do-Not-Resuscitate Orders: An Observational Cohort Study.

Yen-Yuan Chen, Nahida H Gordon, Alfred F Connors, Allan Garland, Tzong-Shinn Chu, Stuart J Youngner

Open access · goldAbstract readObservational Study
In one paragraph

Observational study in Medicine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact, top 79% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 6 citations in OpenAlex.

  1. Article
  2. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 1 institution in 2 countries.

Yen-Yuan ChenFrom the Graduate Institute of Medical Education and Bioethics, National Taiwan University College of Medicine, Department of Medical Education, National Taiwan University Hospital, Taipei, Taiwan (Y-YC, T-SC); Case Western Reserve University School of Nursing (NHG); Department of Medicine, Case Western Reserve University School of Medicine at MetroHealth Medical CenterCleveland, OH, USA (AFC); Department of Community Health Services; Department of Medicine, University of Manitoba, Winnipeg, Canada (AG); and Department of Bioethics, Case Western Reserve University School of Medicine, 10900 Euclid Avenue, Cleveland, OH, USA (SJY).
Nahida H Gordon
Alfred F Connors
Allan Garland
Tzong-Shinn Chu
Stuart J Youngner
Hunan Provincial Agricultural Machinery Authority · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Lack of clarity about the exact clinical implications of do-not-resuscitate (DNR) has caused confusion that has been addressed repeatedly in the literature. To provide improved understanding about the portability of DNR and the medical care provided to DNR patients, the state of Ohio passed a Do-Not-Resuscitate Law in 1998, which clearly pointed out 2 different protocols of do-not-resuscitate: DNR comfort care (DNRCC) and DNR comfort care arrest (DNRCC-Arrest). The objective of this study was to examine the outcome of patients with the 2 different protocols of DNR orders.This is a retrospective observational study conducted in a medical intensive care unit (MICU) in a hospital located in Northeast Ohio. The medical records of the initial admissions to the MICU during data collection period were concurrently and retrospectively reviewed. The association between 2 variables was examined using Chi-squared test or Student's t-test. The outcome of DNRCC, DNRCC-Arrest, and No-DNR patients were compared using multivariate logistic regression analysis.The total of 188 DNRCC-Arrest, 88 DNRCC, and 2051 No-DNR patients were included in this study. Compared with the No-DNR patients, the DNRCC (odds ratio = 20.77, P < 0.01) and DNRCC-Arrest (odds ratio = 3.69, P < 0.01) patients were more likely to die in the MICU. Furthermore, the odds of dying during MICU stay for DNRCC patients were 7.85 times significantly higher than that for DNRCC-Arrest patients (odds ratio = 7.85, P < 0.01).Given Do-Not-Resuscitate Law in Ohio, we examined the outcome of the 2 different protocols of DNR orders, and to compare with the conventional DNR orders. Similar to conventional DNR, DNDCC and DNRCC-Arrest were both associated with the increased risk of death. Patients with DNRCC were more likely to be associated with increased risk of death than those with DNRCC-Arrest.

Indexed as

Resuscitation OrdersAdultAgedAPACHEClinical ProtocolsFemaleHeart ArrestHumansLogistic ModelsMaleMiddle AgedOhioRetrospective Studies

Identifiers

PMID26496311
PMCPMC4620758
OpenAlexW2332882355

What OpenQuestion holds

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LicenceCC BY-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.