ArticleBMC palliative care2024
Characteristics and outcomes of patients with do-not-resuscitate and physician orders for life-sustaining treatment in a medical intensive care unit: a retrospective cohort study.
Article in BMC palliative care, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- Awareness, attitudes, and educational needs regarding the life-sustaining treatment decision-making act in Korea among healthcare providers and medical students: a comparative analysis.BMC medical ethics · 2026Article
- End-of-life care among Koreans in critical care and community-dwelling Korean Americans: A cross-cultural scoping review.Palliative & supportive care · 2025Article
- Outcome and critical care resources utilised by do not attempt cardiopulmonary resuscitation (DNACPR) patients admitted to the ICU at a tertiary hospital in Saudi Arabia: a retrospective review of the critical care database.Critical care (London, England) · 2025Article
- Observational
- Factors influencing self-decision in withholding or withdrawal of life-sustaining treatments among older patients admitted to general hospital: A retrospective case-control study.Journal of Korean gerontological nursing · 2025Article
- Early and late code status documentation in cancer patients managed by a dedicated supportive care team.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025Article
- The impact of withholding and withdrawal life-sustaining treatment issues on patients with sepsis: a prospective, nationwide, multicenter cohort study.Scientific reports · 2025Article
- Code Status Transitions of Patients with Aneurysmal Subarachnoid Hemorrhage in the Intensive Care Unit.Palliative medicine reports · 2025Article
- The Predictive Performance of Risk Scores for the Outcome of COVID-19 in a 2-Year Swiss Cohort.Biomedicines · 2024Article
- A Retrospective Analysis of Characteristics Favouring In-Hospital Resuscitation Plan Completion, Their Timing, and Associated Outcomes.Journal of clinical medicine · 2024Article
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Authors and funding
4 authors.
Funding
Abstract
backgroundIn the intensive care unit (ICU), we may encounter patients who have completed a Do-Not-Resuscitate (DNR) or a Physician Orders to Stop Life-Sustaining Treatment (POLST) document. However, the characteristics of ICU patients who choose DNR/POLST are not well understood.
methodsWe retrospectively analyzed the electronic medical records of 577 patients admitted to a medical ICU from October 2019 to November 2020, focusing on the characteristics of patients according to whether they completed DNR/POLST documents. Patients were categorized into DNR/POLST group and no DNR/POLST group according to whether they completed DNR/POLST documents, and logistic regression analysis was used to evaluate factors influencing DNR/POLST document completion.
resultsA total of 577 patients were admitted to the ICU. Of these, 211 patients (36.6%) had DNR or POLST records. DNR and/or POLST were completed prior to ICU admission in 48 (22.7%) patients. The DNR/POLST group was older (72.9 ± 13.5 vs. 67.6 ± 13.8 years, p < 0.001) and had higher Acute Physiology and Chronic Health Evaluation (APACHE) II score (26.1 ± 9.2 vs. 20.3 ± 7.7, p < 0.001) and clinical frailty scale (5.1 ± 1.4 vs. 4.4 ± 1.4, p < 0.001) than the other groups. Solid tumors, hematologic malignancies, and chronic lung disease were the most common comorbidities in the DNR/POLST groups. The DNR/POLST group had higher ICU and in-hospital mortality and more invasive treatments (arterial line, central line, renal replacement therapy, invasive mechanical ventilation) than the other groups. Body mass index, APAHCE II score, hematologic malignancy, DNR/POLST were factors associated with in-hospital mortality.
conclusionsAmong ICU patients, 36.6% had DNR or POLST orders and received more invasive treatments. This is contrary to the common belief that DNR/POLST patients would receive less invasive treatment and underscores the need to better understand and include end-of-life care as an important ongoing aspect of patient care, along with communication with patients and families.
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