کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
5998160 1181437 2014 7 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Clinical PaperPredictors of early care withdrawal following out-of-hospital cardiac arrest
ترجمه فارسی عنوان
مقاله بالینی پیشگامان پیشگیری از برداشت زود هنگام پس از قطع قلب از بیمارستان
کلمات کلیدی
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی کاردیولوژی و پزشکی قلب و عروق
چکیده انگلیسی

AimsTo identify factors that associated with early care withdrawal in out-of-hospital cardiac arrest patients.MethodsData was collected from 189 survivors to hospital admission. Patients were classified by survival status upon hospital discharge, and those who died were categorized into withdrawal vs. no withdrawal of care. Those who had care withdrawn were further subdivided into early care withdrawal i.e. ≤72 h vs. late withdrawal >72 h. Multivariable adjusted odds ratios were used to assess factors associated with early care withdrawal.ResultsOf 189 patients with cardiac arrest, only 36 had advanced directives (19%) and 99 (52%) had care withdrawn. Most patients whose care was withdrawn died in hospital (94/99, 95%), and the remainder died in hospice. Care was withdrawn early ≤72 h in the majority of patients (59/94, 63%). Median time to early care withdrawal was 2 days IQR (1-3). Factors associated with early care withdrawal were age ≥75 years, poor initial neurologic exam, multiple co morbidities, multi-organ failure, lactic acid ≥10 mmol L−1, Caucasian race and absence of bystander CPR. Advance directives did not appear to determine early care withdrawal.ConclusionsAlthough most cardiac arrest patients do not have advance directives, care is often withdrawn in more than 50% and in many before the accepted time for neurological awakening (72 h). The decision to withdraw care is influenced by older age, race, preexisting co morbidities, multi-organ failure, and a poor initial neurological exam. Further studies are needed to better understand this phenomenon and other sociological factors that guide such decisions.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Resuscitation - Volume 85, Issue 11, November 2014, Pages 1455-1461
نویسندگان
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