Early DNR Order and Long-Term Prognosis Among Patients Hospitalized for Acute Heart Failure: Single-Center Cohort Study in Japan.
acute heart failure
advance care planning
early DNR
end of life
prognosis
Journal
International journal of general medicine
ISSN: 1178-7074
Titre abrégé: Int J Gen Med
Pays: New Zealand
ID NLM: 101515487
Informations de publication
Date de publication:
2020
2020
Historique:
received:
05
03
2020
accepted:
18
08
2020
entrez:
16
10
2020
pubmed:
17
10
2020
medline:
17
10
2020
Statut:
epublish
Résumé
An early do-not-resuscitate (DNR) order is classified as such when it occurs within 24 hours of admission. Early DNR has been previously associated with in-hospital mortality among acute heart failure (AHF) patients and one-year mortality among patients discharged from ICU. Here, we investigate whether early DNR is associated with long-term mortality in AHF Japanese patients, by performing a retrospective cohort study. We retrospectively investigated all patients with AHF, admitted to our hospital between April 2013 and March 2015, and survived to discharge. We obtained data on demographics, comorbidities, laboratory and echocardiography results, social background, DNR status, and outcomes (one-year death). The association of early DNR with one-year death was analyzed by multivariate logistic regression analysis. Among 370 survive to discharge patients, 48 (12%) were lost to follow up. We analyzed 322 patients. The median age was 74 years, and 80 (25%) had an early DNR order. Patients with a DNR order were older and displayed more activities of daily living (ADL)-dependence. Early DNR was associated with higher one-year mortality. Early DNR was associated with one-year mortality among AHF patients. Further studies are necessary to investigate unmeasured factors associated with a worse prognosis related to early DNR among AHF patients.
Identifiants
pubmed: 33061541
doi: 10.2147/IJGM.S252651
pii: 252651
pmc: PMC7532062
doi:
Types de publication
Journal Article
Langues
eng
Pagination
721-728Informations de copyright
© 2020 Hiraoka et al.
Déclaration de conflit d'intérêts
The authors report no conflict of interest in this work.
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