Evidence map›Paper›PMID 35284847›Full record

ArticleResuscitation plus2022

Code status orders in patients admitted to the intensive care unit with COVID-19: A retrospective cohort study.

Emily E Moin, Daniel Okin, Sirus J Jesudasen, Nupur A Dandawate, Alexander Gavralidis, Leslie L Chang, Alison S Witkin, Kathryn A Hibbert, Aran Kadar, Patrick L Gordan and 3 more

Open access · goldAbstract read
In one paragraph

Article in Resuscitation plus, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
3.1field-weighted citation impact, top 9% 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

4 citing papers in PubMed, 11 citations in OpenAlex.

  1. Article
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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

13 authors at 4 institutions in 1 country.

Emily E MoinDepartment of Medicine, Massachusetts General Hospital, Boston, MA, USA.
Daniel OkinDepartment of Medicine, Massachusetts General Hospital, Boston, MA, USA.
Sirus J JesudasenDepartment of Medicine, Massachusetts General Hospital, Boston, MA, USA.
Nupur A DandawateDepartment of Medicine, Salem Hospital, Salem, MA, USA.
Alexander GavralidisDepartment of Medicine, Salem Hospital, Salem, MA, USA.
Leslie L ChangDepartment of Medicine, Massachusetts General Hospital, Boston, MA, USA.
Alison S WitkinDivision of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, MA, USA.
Kathryn A HibbertDivision of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, MA, USA.
Aran KadarDivision of Pulmonary Medicine and Critical Care, Newton-Wellesley Hospital, Newton, MA, USA.
Patrick L GordanDepartment of Medicine, Salem Hospital, Salem, MA, USA.
Lisa M BebellDivision of Infectious Diseases, Medical Practice Evaluation Center and Center for Global Health, Massachusetts General Hospital, Boston, MA, USA.
Peggy S LaiDivision of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, MA, USA.
George A AlbaDivision of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, MA, USA.
Massachusetts General Hospital · USSalem Hospital · USCenter for Global Health · USNewton Wellesley Hospital · US

Funding

Institutional Career Development CoreKL2TR002542 · NCATS · HARVARD MEDICAL SCHOOL · PI BREDELLA, MIRIAM ANTOINETTE, RUTKOVE, SEWARD B. · 2018 to 2022
$8.7M
Research Training in Pulmonary Immunology and Allergy at MGHT32HL116275 · NHLBI · MASSACHUSETTS GENERAL HOSPITAL · PI David C Christiani, ANDREW D LUSTER · 2013 to 2026
$8.6M
NCATS NIH HHS KL2 TR002542NHLBI NIH HHS T32 HL116275
6 · The paper itself

Abstract

Purpose: Code status orders impact clinical outcomes as well as patients' and surrogates' experiences. This is the first multicenter cohort examining code status orders of ICU patients with COVID-19 reported to date. Materials and methods: This is a retrospective cohort study including adult patients who tested positive for SARS-CoV-2 and were admitted to the ICU at three hospitals in Massachusetts from March 11, 2020 - May 31, 2020. We examined differences in code status orders at multiple timepoints and performed multivariable regression analysis to identify variables associated with code status at admission. Results: Among 459 ICU patients with COVID-19, 421 (91.7%) were Full Code at hospital admission. Age and admission from a facility were positively associated with DNR status (adjusted OR 1.10, 95% CI 1.05-1.15, p < 0.001 and adjusted OR 2.68, CI 1.23-5.71, p = 0.011, respectively) while non-English preferred language was negatively associated with DNR status (adjusted OR 0.29, 95% CI 0.10-0.74, p = 0.012). Among 147 patients who died during hospitalization, 95.2% (140) died with DNR code status; most (86.4%) died within two days of final code status change. Conclusions: The association of non-English preferred language with Full Code status in critically ill COVID-19 patients highlights the importance of medical interpreters in the ICU. Patients who died were transitioned to DNR more than in previous studies, possibly reflecting changes in practice during a novel pandemic.

Indexed as

Code statusCOVID-19Critical care

Identifiers

PMID35284847
PMCPMC8898738
OpenAlexW4220812191

What OpenQuestion holds

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Registered trials

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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.