No registrations found.
ID
Source
Brief title
Health condition
DNACPR orders, DNR order, DNAR order, CPR, CPR status, descriptive, ED
Beleidsbeperking, behandelbeperking, NR beleid, reanimatie, SEH
Sponsors and support
Spaarne gasthuis
No companies, NGO's or other governmental organizations involved.
The reasearchers have nothing to declare.
Intervention
Outcome measures
Primary outcome
frequency of change in CPR status (as determined in the ED) during hospital stay
Secondary outcome
We plan to perform subgroup analyses to determine the patient characteristics that correlate with the group of patients for whom the CPR status was changed.
We determined the following patient characteristics:
- age (18-40, 40-50, 50-60, 60-70, 70-80, 80+)
- sex (F/M/other)
- amount of hospital admissions in the previous year (<3, =>3)
- comorbidities classified (using ICD-10 codes registered as part of the DBC system) as:
1. neoplasms
2. diabetes mellitus
3. liver insufficiency
4. cardiovascular disease
5. chronic respiratory disease
6. renal insufficiency
- ICU admissions (direct, delayed, no admission)
- compounded surrogate measure of frailty, yet to be defined
- reason for change in CPR status (medical futility/patient preference/not specified)
- family present during end-of-life conversation (yes/no/not specified)
- in case of IHCA: survivor or non-survivor
Predefined hospital and other characteristics:
- time of ED presentation (day shift 7:00-15:00, evening shift 15:00-22:00, night shift 22:00-7:00)
- which doctor registers CPR status (junior vs senior, ED vs other specialty)
- differences between hospitals
- in Westfriesgasthuis patients: comparison between frequency of CPR status registration in the ED and change in CPR status during admission before and after change of protocol (February 2017)
Background summary
In many Dutch hospitals hospital admission from the emergency department (ED) requires registration of resuscitation orders. There is an ongoing debate addressing whether it is necessary to raise the end-of-life discussion with all patients admitted from the ED and whether the ED is really the most appropriate place to discuss such sensitive matters. This debate is primarily fed by ethical arguments. However, quantitative data on current CPR status registration practice and its effectiveness is lacking. The current proposal describes a multicenter retrospective case analysis aiming to generate these objective data to feed into this debate.
Study objective
With this descriptive study we aim to acquire more insight into the current practice of obligatory resuscitation order registration in the emergency department and to address its effectiveness.
Study design
1-2018 protocol finished and acquire ethical approval
5-2018 data extracted from electronic patient files in all hospitals
7-2018 finish preparation of data set for analyses
8-2018 analysis
12-2018 first draft result report finished
Intervention
none
Inclusion criteria
All adult patients admitted from the ED from participating hospitals
Exclusion criteria
none
Design
Recruitment
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
| Register | ID |
|---|---|
| NTR-new | NL6624 |
| NTR-old | NTR6954 |
| Other | METC : M018-003 |