ArticleBMJ open2021
Code status documentation at admission in COVID-19 patients: a descriptive cohort study.
Article in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Predicting neurological outcome in adult patients with cardiac arrest: systematic review and meta-analysis of prediction model performance.Critical care (London, England) · 2022Pooled it
- Physicians' training and patient education initiative to improve quality of care decision communication at the emergency department.BMJ open quality · 2024Article
- Impact of the COVID-19 Public Health Crisis and a Structured COVID Unit on Physician Behaviors in Code Status Ordering.The American journal of hospice & palliative care · 2024Article
- Effect of the COVID-19 pandemic on the care for acute cholecystitis: a Swedish multicentre retrospective cohort study.BMJ open · 2023Article
- Change in Code Status Orders of Hospitalized Adults With COVID-19 Throughout the Pandemic: A Retrospective Cohort Study.Journal of palliative medicine · 2023Article
- Shared decision-making in advance care planning among hospitalized older COVID-19 patients: a multicenter, retrospective cohort study.Aging clinical and experimental research · 2022Article
- Code status documentation at admission in COVID-19 patients: a descriptive cohort study.BMJ open · 2021Article
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Authors and funding
8 authors.
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No grant is acknowledged in the PubMed record.
Abstract
objectivesThe COVID-19 pandemic pressurised healthcare with increased shortage of care. This resulted in an increase of awareness for code status documentation (ie, whether limitations to specific life-sustaining treatments are in place), both in the medical field and in public media. However, it is unknown whether the increased awareness changed the prevalence and content of code status documentation for COVID-19 patients. We aim to describe differences in code status documentation between infectious patients before the pandemic and COVID-19 patients.
settingUniversity Medical Centre of Utrecht, a tertiary care teaching academic hospital in the Netherlands.
participantsA total of 1715 patients were included, 129 in the COVID-19 cohort (a cohort of COVID-19 patients, admitted from March 2020 to June 2020) and 1586 in the pre-COVID-19 cohort (a cohort of patients with (suspected) infections admitted between September 2016 to September 2018). PRIMARY AND SECONDARY OUTCOME MEASURES: We described frequency of code status documentation, frequency of discussion of this code status with patient and/or family, and content of code status.
resultsFrequencies of code status documentation (69.8% vs 72.7%, respectively) and discussion (75.6% vs 73.3%, respectively) were similar in both cohorts. More patients in the COVID-19 cohort than in the before COVID-19 cohort had any treatment limitation as opposed to full code (40% vs 25%). Within the treatment limitations, 'no intensive care admission' (81% vs 51%) and 'no intubation' (69% vs 40%) were more frequently documented in the COVID-19 cohort. A smaller difference was seen in 'other limitation' (17% vs 9%), while 'no resuscitation' (96% vs 92%) was comparable between both periods.
conclusionWe observed no difference in the frequency of code status documentation or discussion in COVID-19 patients opposed to a pre-COVID-19 cohort. However, treatment limitations were more prevalent in patients with COVID-19, especially 'no intubation' and 'no intensive care admission'.
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