ArticleBMC geriatrics2024
Decisions about the limitations of life-sustaining treatment for acutely admitted older patients: a retrospective study of a Danish patient cohort.
Article in BMC geriatrics, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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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.
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Who cites it
2 citing papers in PubMed.
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLife-sustaining therapy, including heart and lung resuscitation and transfer to the intensive care department, is demanding for patients and relatives and utilizes large amounts of healthcare resources. For older patients acutely admitted to the hospital, very sparse data exist on decision making about life-sustaining therapy.
methodsRetrospective data were extracted from patients ≥ 70 years old who were acutely admitted to the hospital. Age, sex, clinical frailty scale score and Charlson comorbidity index were manually extracted from patients' files. Furthermore, data about life-sustaining treatment decisions were extracted. This was further divided into decisions documented within 24 h from admission or during the hospital stay.
resultsData were extracted for 200 patients with a median age of 80 years. Patients had a Charlson Comorbidity Index of 6 (5-8 IQR) and a Clinical Frailty Scale (CFS) score of 5 (3-6 IQR). During the first 24 h, 61 patients (30.5%) had a written decision about heart and cardiopulmonary resuscitation (CPR), and 52 patients (26%) had written information about intensive care therapy. A total of 93 patients (46.5%) had a written decision about cardiopulmonary resuscitation (CPR), intensive care therapy or both during their hospital stay. With increasing Charlson Comorbidity Index and Clinical Frailty Scale scores, more patients had decisions about limitations in therapy documented in their files.
conclusionsWithin the first 24 h, 30.5% of the patients had a written decision about cardiopulmonary resuscitation (CPR), and 26% had written information about intensive care therapy. These numbers increased to 46.5% of patients who had a decision made during their hospital stay whether they were candidates for either cardiopulmonary resuscitation (CPR), intensive care therapy or both. These data suggest that further work should be done to determine the limitations of therapy early on the admission for all older frail acutely admitted patients.
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