Korean J Hosp Palliat Care.  2016 Mar;19(1):26-33. 10.14475/kjhpc.2016.19.1.26.

Clinical Characteristics of Oncologic Patients with DNR Decision at a Tertiary Hospital

• Kang NY
• Park JY

• KMID: 2156241
• DOI: http://doi.org/10.14475/kjhpc.2016.19.1.26

Abstract

PURPOSE
This study was conducted to identify clinical characteristics of oncologic patients at a point when they signed their do-not-resuscitate (DNR) orders.
METHODS
From January through December 2014, we retrospectively analyzed the records of 197 patients who passed away after agreeing to a DNR order in the hemato-oncology department of a tertiary hospital.
RESULTS
Of all, 121 patients (61.4%) were male and 76 (38.6%) were female, and their average age was 58.7 years. Ninety-four patients (47.7%) had gastrointestinal cancer. The ECOG performance status at admission was grade 3 in 76 patients (36.5%) and grade 4 in 11 (5.6%). The patients' mean hospital stay was 20 days. The mean duration from the admission to DNR decision was 13 days, and the mean duration from DNR decision to death was seven days.
CONCLUSION
Study results indicate that a decision on signing or refusing a DNR order was made by medical staff mostly based on the opinions of patients' guardians rather than the patients themselves. This suggests that patients' own wishes are not well respected. Thus, it is urgent to establish institutional devices to enhance cancer patients' autonomy regarding DNR and to define an adequate timing for withdrawal of treatments.

Keyword

Terminally ill; Neoplasms; Resuscitation orders; Terminal care; Hospice care

MeSH Terms

Female
Gastrointestinal Neoplasms
Hospice Care
Humans
Length of Stay
Male
Medical Staff
Resuscitation Orders
Retrospective Studies
Terminal Care
Terminally Ill
Tertiary Care Centers*