Patients' characteristics associated with the decision of “do not attempt cardiopulmonary resuscitation” order in a Swiss hospital

• We assessed the prevalence and determinants of DNACPR order in a Swiss hospital.
• 53% of the patients had a DNACPR order with 61% decided by the medical team.
• Determinants associated with doctors' decision are old age and oncologic pathology.
• The determinant associated with patients' decision is protestant religion.

BackgroundAccording to Swiss legislation, do not attempt cardiopulmonary resuscitation (DNACPR) order can be made at any time by patients only, unless the resuscitation is considered as futile, based on the doctors' evaluation. Little is known about how this decision is made, and which are the factors influencing this decision.MethodsObservational, cross-sectional study was conducted between March and May 2013 on 194 patients hospitalized in the general internal medicine ward of a Swiss hospital. The associations between patients' DNACPR orders and gender, age, marital status, nationality, religion, number and type of comorbidities were assessed.Results102 patients (53%) had a DNACPR order: 27% issued by the patient him/herself, 12% by his/her relatives and 61% by the medical team. Patients with a DNACPR order were significantly older: 80.7 ± 10.8 vs. 67.5 ± 15.1 years in the “with” and “without” DNACPR order group, respectively, p < 0.001. Oncologic disease was associated with a DNACPR order issued by the medical team (37.5% vs. 16.9% in the “with” and “without” DNACPR order group, respectively, p < 0.05). Being protestant was associated with a DNACPR order issued by the patient (57.9% vs. 25.9% in the “with” and “without” DNACPR order group, respectively p < 0.01).ConclusionsOver half of the patients admitted to a general internal medicine ward had a DNACPR order issued within the first 72 h of hospitalization. Older age and oncologic disease were associated with a DNACPR decision by the medical team, while protestant religion was associated with a DNACPR decision by the patient.