Evidence map›Paper›PMID 35764202›Full record

ArticleJournal of pain and symptom management2022

Admission Code Status and End-of-life Care for Hospitalized Patients With COVID-19.

Whitney A Kiker, Si Cheng, Lauren R Pollack, Claire J Creutzfeldt, Erin K Kross, J Randall Curtis, Katherine A Belden, Roman Melamed, Donna Lee Armaignac, Smith F Heavner and 12 more

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

Article in Journal of pain and symptom management, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
1.8field-weighted citation impact, top 16% 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

6 citing papers in PubMed, 9 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

22 authors at 15 institutions in 2 countries.

Whitney A KikerDivision of Pulmonary, Critical Care and Sleep Medicine (W.A.K., L.R.P., E.K.K., J.R.C., ), University of Washington, Seattle, WA, USA; Cambia Palliative Care Center of Excellence (WA.K., L.R.P., C.J.C., E.K.K., J.R.C., N.K.), University of Washington, Seattle, WA, USA. Electronic address: wkiker@uw.edu.
Si ChengDepartment of Biostatistics (S.C.), University of Washington, Seattle, WA, USA.
Lauren R PollackDivision of Pulmonary, Critical Care and Sleep Medicine (W.A.K., L.R.P., E.K.K., J.R.C., ), University of Washington, Seattle, WA, USA; Cambia Palliative Care Center of Excellence (WA.K., L.R.P., C.J.C., E.K.K., J.R.C., N.K.), University of Washington, Seattle, WA, USA.
Claire J CreutzfeldtCambia Palliative Care Center of Excellence (WA.K., L.R.P., C.J.C., E.K.K., J.R.C., N.K.), University of Washington, Seattle, WA, USA; Department of Neurology, Harborview Medical Center (C.J.C.), University of Washington, Seattle, WA, USA.
Erin K KrossDivision of Pulmonary, Critical Care and Sleep Medicine (W.A.K., L.R.P., E.K.K., J.R.C., ), University of Washington, Seattle, WA, USA; Cambia Palliative Care Center of Excellence (WA.K., L.R.P., C.J.C., E.K.K., J.R.C., N.K.), University of Washington, Seattle, WA, USA.
J Randall CurtisDivision of Pulmonary, Critical Care and Sleep Medicine (W.A.K., L.R.P., E.K.K., J.R.C., ), University of Washington, Seattle, WA, USA; Cambia Palliative Care Center of Excellence (WA.K., L.R.P., C.J.C., E.K.K., J.R.C., N.K.), University of Washington, Seattle, WA, USA.
Katherine A BeldenDivision of Infectious Diseases (K.A.B.), Thomas Jefferson University Hospital, Philadelphia, PA, USA.
Roman MelamedAbbott Northwestern Hospital (R.M.), Allina Health, Minneapolis, MN, USA.
Donna Lee ArmaignacCenter for Advanced Analytics (D.L.A.), Baptist Health South Florida, Miami, FL, USA.
Smith F HeavnerDepartment of Public Health Sciences (S.F.H.), Clemson University, Clemson, SC, USA.
Amy B ChristieDepartment of Critical Care (A.B.C.), Atrium Health Navicent, Macon, GA, USA.
Valerie M Banner-GoodspeedDepartment of Anesthesia, Critical Care & Pain Medicine (V.M.B-G.), Beth Israel Deaconess Medical Center, Boston, MA, USA.
Ashish K KhannaDepartment of Anesthesiology, Section on Critical Care Medicine (A.K.K.), Perioperative Outcomes and Informatics Collaborative (POIC), Wake Forest School of Medicine, Atrium Health Wake Forest Baptist, Winston-Salem, NC, USA; Outcomes Research Consortium (A.K.K.), Cleveland, OH, USA.
Uluhan SiliDepartment of Infectious Diseases and Clinical Microbiology, School of Medicine (U.S.), Marmara University, Istanbul, Turkey.
Harry L AndersonDepartment of Surgery (H.L.A.), St Joseph Mercy Ann Arbor, Ann Arbor, MI, USA.
Vishakha KumarSociety of Critical Medicine (V.K.), Mount Prospect, IL, USA.
Allan WalkeyThe Pulmonary Center, Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, and Evans Center of Implementation and Improvement Sciences, Department of Medicine (A.W.), Boston University School of Medicine, Boston, MA, USA.
Rahul KashyapDivision of Pulmonary and Critical Care Medicine (R.K., O.G.), Mayo Clinic, Rochester, MN, USA.
Ognjen GajicDivision of Pulmonary and Critical Care Medicine (R.K., O.G.), Mayo Clinic, Rochester, MN, USA.
Juan Pablo DomecqDivision of Nephrology and Hypertension (J.P.D.), Mayo Clinic, Rochester, MN, USA; Department of Critical Care Medicine (J.P.D.), Mayo Clinic, Mankato, MN, USA.
Nita KhandelwalCambia Palliative Care Center of Excellence (WA.K., L.R.P., C.J.C., E.K.K., J.R.C., N.K.), University of Washington, Seattle, WA, USA; Department of Anesthesiology and Pain Medicine (N.K.), University of Washington, Seattle, WA, USA.
Society of Critical Care Medicine Discovery Viral Infection and Respiratory Illness Universal Study (VIRUS): COVID-19 Registry Investigator Group
University of Washington · USMayo Clinic · USAbbott Northwestern Hospital · USAtrium Health Wake Forest Baptist · USBaptist Health South Florida · USBeth Israel Deaconess Medical Center · USClemson University · USHarborview Medical Center · USMarmara University · TRMayo Clinic in Arizona · USNavicent Health · USPulmonary and Allergy Associates · USSociety of Critical Care Medicine · USThomas Jefferson University Hospital · USTrinity Health Ann Arbor Hospital · US

Funding

Mayo Clinic Center for Clinical and Translational Science (CCaTS UL1 Supplement - Dr. Timothy Curry)UL1TR002377 · NCATS · MAYO CLINIC ROCHESTER · PI VESNA D GAROVIC · 2017 to 2026
$78.4M
Palliative Care Research Training GrantT32HL125195 · NHLBI · UNIVERSITY OF WASHINGTON · PI KROSS, ERIN KATHRYN, SHARMA, RASHMI K. · 2015 to 2024
$3.2M
Improving patient- and family-centered outcomes and value of care for patients with chronic illness who develop acute respiratory failureK23HL144830 · NHLBI · UNIVERSITY OF WASHINGTON · PI KHANDELWAL, NITA · 2019 to 2022
$715k
NCATS NIH HHS UL1 TR002377NHLBI NIH HHS K23 HL144830NHLBI NIH HHS T32 HL125195
6 · The paper itself

Abstract

contextThe COVID-19 pandemic has highlighted variability in intensity of care. We aimed to characterize intensity of care among hospitalized patients with COVID-19.

objectivesExamine the prevalence and predictors of admission code status, palliative care consultation, comfort-measures-only orders, and cardiopulmonary resuscitation (CPR) among patients hospitalized with COVID-19.

methodsThis cross-sectional study examined data from an international registry of hospitalized patients with COVID-19. A proportional odds model evaluated predictors of more aggressive code status (i.e., Full Code) vs. less (i.e., Do Not Resuscitate, DNR). Among decedents, logistic regression was used to identify predictors of palliative care consultation, comfort measures only, and CPR at time of death.

resultsWe included 29,923 patients across 179 sites. Among those with admission code status documented, Full Code was selected by 90% (n = 15,273). Adjusting for site, Full Code was more likely for patients who were of Black or Asian race (ORs 1.82, 95% CIs 1.5-2.19; 1.78, 1.15-3.09 respectively, relative to White race), Hispanic ethnicity (OR 1.89, CI 1.35-2.32), and male sex (OR 1.16, CI 1.0-1.33). Of the 4951 decedents, 29% received palliative care consultation, 59% transitioned to comfort measures only, and 29% received CPR, with non-White racial and ethnic groups less likely to receive comfort measures only and more likely to receive CPR.

conclusionIn this international cohort of patients with COVID-19, Full Code was the initial code status in the majority, and more likely among patients who were Black or Asian race, Hispanic ethnicity or male. These results provide direction for future studies to improve these disparities in care.

Indexed as

COVID-19Terminal CareCross-Sectional StudiesHumansMalePandemicsResuscitation OrdersRetrospective StudiesCOVIDEnd of lifePalliative care

Identifiers

PMID35764202
PMCPMC9233554
OpenAlexW4283512016

What OpenQuestion holds

Textmetadata
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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.