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影响大学医院重症监护病房患者意愿表达的因素。

Factors affecting code status in a university hospital intensive care unit.

机构信息

Department of Internal Medicine and Division of Pulmonary, Critical Care and Sleep Medicine, Drexel University College of Medicine, Philadelphia, Pennsylvania 19102, USA.

出版信息

Death Stud. 2013 Sep;37(8):768-81. doi: 10.1080/07481187.2012.699908.

Abstract

The authors collected data on diagnosis, hospital course, and end-of life preparedness in patients who died in the intensive care unit (ICU) with '"full code" status (defined as receiving cardiopulmonary resuscitation), compared with those who didn't. Differences were analyzed using binary and stepwise logistic regression. They found no differences in demographics, comorbidities, ventilator, hospital, or ICU days between groups. No-code patients were more likely to have higher APACHE-II scores (p < .0001), gastrointestinal/hepatic conditions (p < .01) and an advanced directive (p = .03). Patients dying with full code status were more likely to have previously coded (p < .0001), and had more central lines (p = .03). Implications are discussed.

摘要

作者收集了在重症监护病房(ICU)死亡的“全面复苏”(定义为接受心肺复苏)患者与未接受该治疗的患者的诊断、住院过程和临终准备的数据。使用二项和逐步逻辑回归分析差异。他们发现两组在人口统计学、合并症、呼吸机、住院或 ICU 天数方面没有差异。无复苏意愿的患者更有可能具有更高的急性生理学和慢性健康评估评分(p<0.0001)、胃肠道/肝脏疾病(p<0.01)和预先制定的医疗指示(p=0.03)。有全面复苏意愿的患者更有可能之前已经被编码(p<0.0001),并且有更多的中央导管(p=0.03)。讨论了这些结果的意义。

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