Evidence map›Paper›PMID 32949762›Full record

ArticleJournal of pain and symptom management2021

Discordant Cardiopulmonary Resuscitation and Code Status at Death.

Alexandria J Robbins, Nicholas E Ingraham, Adam C Sheka, Kathryn M Pendleton, Rachel Morris, Alexander Rix, Victor Vakayil, Jeffrey G Chipman, Anthony Charles, Christopher J Tignanelli

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of pain and symptom management, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
1.3field-weighted citation impact, top 18% 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

8 citing papers in PubMed, 14 citations in OpenAlex.

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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

10 authors at 4 institutions in 1 country.

Alexandria J RobbinsDepartment of Surgery, University of Minnesota Medical School, Minneapolis, Minnesota, USA. Electronic address: cough083@umn.edu.
Nicholas E IngrahamDepartment of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, USA.
Adam C ShekaDepartment of Surgery, University of Minnesota Medical School, Minneapolis, Minnesota, USA.
Kathryn M PendletonDepartment of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, USA.
Rachel MorrisDepartment of Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
Alexander RixDepartment of Biostatistics, University of Michigan School of Public Health, Ann Arbor, Michigan, USA.
Victor VakayilDepartment of Surgery, University of Minnesota Medical School, Minneapolis, Minnesota, USA.
Jeffrey G ChipmanDepartment of Surgery, University of Minnesota Medical School, Minneapolis, Minnesota, USA; Department of Surgery, North Memorial Health Hospital, Robbinsdale, Minnesota, USA.
Anthony CharlesDepartment of Surgery, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA; School of Public Health, University of North Carolina, Chapel Hill, North Carolina, USA.
Christopher J TignanelliDepartment of Surgery, University of Minnesota Medical School, Minneapolis, Minnesota, USA; Department of Surgery, North Memorial Health Hospital, Robbinsdale, Minnesota, USA; Institute for Health Informatics, University of Minnesota Academic Health Center, Minneapolis, Minnesota, USA.
University of Minnesota Medical Center · USMedical College of Wisconsin · USUniversity of Michigan–Ann Arbor · USUniversity of North Carolina at Chapel Hill · US

Funding

University of Minnesota Clinical and Translational Science Institute (UMN CTSI)UL1TR002494 · NCATS · UNIVERSITY OF MINNESOTA · PI BLAZAR, BRUCE R, WEISDORF, DANIEL J · 2018 to 2022
$34.9M
TRAINING-PULMONARY CELL &MOLECULAR BIOLOGY &PHYSIOLOGYT32HL007741 · NHLBI · UNIVERSITY OF MINNESOTA TWIN CITIES · PI DUDLEY, R. ADAMS, INGBAR, DAVID H · 1994 to 2023
$13.9M
NCATS NIH HHS UL1 TR002494NHLBI NIH HHS T32 HL007741
6 · The paper itself

Abstract

contextOne fundamental way to honor patient autonomy is to establish and enact their wishes for end-of-life care. Limited research exists regarding adherence with code status.

objectivesThis study aimed to characterize cardiopulmonary resuscitation (CPR) attempts discordant with documented code status at the time of death in the U.S. and to elucidate potential contributing factors.

methodsThe Cerner Acute Physiology and Chronic Health Evaluation (APACHE) outcomes database, which includes 237 U.S. hospitals that collect manually abstracted data from all critical care patients, was queried for adults admitted to intensive care units with a documented code status at the time of death from January 2008 to December 2016. The primary outcome was discordant CPR at death. Multivariable logistic regression models were used to identify patient-level and hospital-level associated factors after adjustment for age, hospital, and illness severity (APACHE III score).

resultsA total of 21,537 patients from 56 hospitals were included. Of patients with a do-not-resuscitate code status, 149 (0.8%) received CPR at death, and associated factors included black race, higher APACHE III score, or treatment in small or nonteaching hospitals. Of patients with a full code status, 203 (9.0%) did not receive CPR at death, and associated factors included higher APACHE III score, primary neurologic or trauma diagnosis, or admission in a more recent year.

conclusionAt the time of death, 1.6% of patients received or did not undergo CPR in a manner discordant with their documented code statuses. Race and institutional factors were associated with discordant resuscitation, and addressing these disparities may promote concordant end-of-life care in all patients.

Indexed as

Cardiopulmonary ResuscitationTerminal CareAdultAPACHEHospitalizationHumansIntensive Care UnitsResuscitation Orderscardiopulmonary resuscitationCode statusdiscordant care

Identifiers

PMID32949762
PMCPMC8052631
OpenAlexW3085019391

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

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.