Soonchunhyang Med Sci.  2018 Dec;24(2):181-187. 10.0000/sms.2018.24.2.181.

A Retrospective Study on the Decision to Prohibit Cardiopulmonary Resuscitation in Patients with Premenarcheal Cancer in a University Hospital

• Shin IS
• Kim HJ
• Yun J
• Kim SH
• Kim CK
• Park SK
• Hong DS

• KMID: 2437870
• DOI: http://doi.org/10.0000/sms.2018.24.2.181

Abstract

OBJECTIVE
Whether to perform cardiopulmonary resuscitation (CPR) or do-not-resuscitate (DNR) is not only a medical problem but also a decision that should be made carefully with self-autonomy in accordance with life values. We conducted a retrospective observational study to identify the characteristics of current CPR and DNR at a practical level.
METHODS
We retrospectively analyzed data from medical records with regard to the clinical status of DNR decision in 356 patients with cancer who expired between October 2014 and September 2015 in Soonchunhyang University Bucheon Hospital.
RESULTS
DNR was decided significantly more frequently in patients with solid cancers than in patients with hematological cancer (87.7% vs. 71.4%, P=0.003). No other significant factor influenced the DNR decision in this study. The main persons who signed the DNR consent form were mostly sons or daughters (60.7%), never the patients themselves. The median time from the DNR order to death was longer in the ward than in the intensive care unit (ICU; 3.0 days vs. 1.0 days). The mean time from the DNR order to death was 6.6 days (median, 2 days). Among the patients with a DNR order, 110 (36.7%) were hospitalized in the ICU and 73 (24.3%) were treated with ventilator support.
CONCLUSION
Most patients expired 6.6 days after DNR permission was given and could not decide their treatment plan by themselves. For better end-of-life care, the sensitive DNR decision with consideration of the individualized environment of the patient for life-sustaining treatment should be settled in Korea.

Keyword

Resuscitation orders; Terminal care; Neoplasm

MeSH Terms

Cardiopulmonary Resuscitation*
Consent Forms
Gyeonggi-do
Humans
Intensive Care Units
Korea
Medical Records
Nuclear Family
Observational Study
Resuscitation Orders
Retrospective Studies*
Terminal Care
Ventilators, Mechanical