ArticleInternational journal of emergency medicine2024
Do-not-attempt-resuscitation decision making: physicians' recommendations differ from the GO-FAR score predictions.
Article in International journal of emergency medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07243041 (A Prospective Study Exploring Factors Affecting ICU Transitions and Handling of Code Status - Insights Into Physician and Family Communication in a Muslim Patient Population), which is not on this map. Cited by 1 paper.
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A Prospective Study Exploring Factors Affecting ICU Transitions and Handling of Code Status - Insights Into Physician and Family Communication in a Muslim Patient Population
Who cites it
1 citing paper in PubMed.
- Withdrawal/Withholding of Life-Sustaining Therapies: Limitation of Therapeutic Effort in the Intensive Care Unit.Medicina (Kaunas, Lithuania) · 2024Observational
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8 authors.
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No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
aimIn-hospital cardiac arrest (IHCA) is a major cause of mortality globally, and over 50% of the survivors will require institutional care as a result of poor neurological outcome. It is important that physicians discuss the likely outcome of resuscitation with patients and families during end-of-life discussions to help them with decisions about cardiopulmonary resuscitation. We aim to compare three consultants' do-not-resuscitate (DNR) decisions with the GO-FAR score predictions of the probability of survival with good neurological outcomes following in-hospital cardiac arrest (IHCA).
methodsThis is a retrospective study of all patients 18 years or older placed on a DNR order by a consensus of three consultants in a tertiary institution in the United Arab Emirates over 12 months. Patients' socio-demographics and the GO-FAR variables were abstracted from the electronic medical records. We applied the GO-FAR score and the probability of survival with good neurological outcomes for each patient.
resultsA total of 788 patients received a DNR order, with a median age of 71 years and a majority being males and expatriates. The GO-FAR model categorized 441 (56%) of the patients as having a low or very low probability of survival and 347 (44%) as average or above. There were 219 patients with a primary diagnosis of cancer, of whom 148 (67.6%) were in the average and above-average probability groups. There were more In-hospital deaths among patients in the average and above-average probability of survival group compared with those with very low and low probability (243 (70%) versus 249 (56.5%) (P < 0.0001)). The DNR patients with an average or above average chance of survival by GO-FAR score were more likely to be expatriates, oncology patients, and did not have sepsis.
conclusionsThe GO-FAR score provides a guide for joint decision-making on the possible outcomes of CPR in the event of IHCA. The physicians' recommendation and the ultimate patient's resuscitation choice may differ due to more complex contextual medico-social factors.
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