Predictive factors for do-not-resuscitate designation among terminally ill cancer patients receiving care from a palliative care consultation service.

Title

Predictive factors for do-not-resuscitate designation among terminally ill cancer patients receiving care from a palliative care consultation service.

Creator

Kao Chen-Yi; Wang Hung-Ming; Tang Shu-Chuan; Huang K-G; Jaing T-H; Liu Chien-Ying; Liu Keng-Hao; Shen W-C; Wu Jin-Hou; Hung Y-S; Hsu H-C; Chen JS; Liau Chi-Ting; Lin Yung-Chang; Su Po-Jung; Hsieh C-H; Chou WC

Publisher

Journal Of Pain And Symptom Management

Date

2014

Subject

Female; Humans; Male; Prognosis; Aged; Middle Aged; Sex Factors; Multivariate Analysis; Time Factors; retrospective studies; DNAR; Taiwan; Resuscitation Orders; Palliative Care; Neoplasms/th [Therapy]; referral and consultation; Terminally Ill; Family/px [Psychology]; Liver Neoplasms/di [Diagnosis]; Liver Neoplasms/pp [Physiopathology]; Liver Neoplasms/px [Psychology]; Liver Neoplasms/th [Therapy]; Neoplasms/di [Diagnosis]; Neoplasms/pp [Physiopathology]; Neoplasms/px [Psychology]; Resuscitation Orders/px [Psychology]; Terminally Ill/px [Psychology]

Description

CONTEXT: Since the development of palliative care in the 1980s, "do not resuscitate" (DNR) has been promoted worldwide to avoid unnecessary resuscitation in terminally ill cancer patients., OBJECTIVES: This study aimed to evaluate the effect of a palliative care consultation service (PCCS) on DNR designation and to identify a subgroup of patients who would potentially benefit from care by the PCCS with respect to DNR designation., METHODS: In total, 2995 terminally ill cancer patients (with a predicted life expectancy of less than six months by clinician estimate) who received care by the PCCS between January 2006 and December 2010 at a single medical center in Taiwan were selected. Among these, the characteristics of 2020 (67.4%) patients who were not designated as DNR at the beginning of care by the PCCS were retrospectively analyzed to identify variables pertinent to DNR designation., RESULTS: A total of 1301 (64%) of 2020 patients were designated as DNR at the end of care by the PCCS. Male gender and primary liver cancer were characteristics more predominantly found among DNR-designated patients who also had worse performance status, higher prevalence of physical distress, and shorter intervals from palliative care referral to death than did patients without DNR designation. On univariate analysis, a higher probability of DNR designation was associated with male gender, duration of care by the PCCS of more than 14 days, patients' prognostic awareness, family's diagnostic and prognostic awareness, and high Palliative Prognostic Index (PPI) scores. On multivariate analysis, duration of care by the PCCS, patients' prognostic awareness, family's diagnostic and prognostic awareness, and a high PPI score constituted independent variables predicting DNR-designated patients at the end of care by the PCCS., CONCLUSION: DNR designation was late in terminally ill cancer patients. DNR-designated cancer patient indicators were high PPI scores, patients' prognostic awareness, family's diagnostic and prognostic awareness, and longer durations of care by the PCCS.Copyright © 2014 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.
2014

Rights

Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).

Type

Journal Article

Citation List Month

Backlog

Pages

271-82

Issue

2

Volume

47

Citation

Kao Chen-Yi; Wang Hung-Ming; Tang Shu-Chuan; Huang K-G; Jaing T-H; Liu Chien-Ying; Liu Keng-Hao; Shen W-C; Wu Jin-Hou; Hung Y-S; Hsu H-C; Chen JS; Liau Chi-Ting; Lin Yung-Chang; Su Po-Jung; Hsieh C-H; Chou WC, “Predictive factors for do-not-resuscitate designation among terminally ill cancer patients receiving care from a palliative care consultation service.,” Pediatric Palliative Care Library, accessed August 2, 2021, https://pedpalascnetlibrary.omeka.net/items/show/15047.

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