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  • Time for a do-not-resuscitate policy? outcomes of inpatient cardiopulmonary resuscitation in very old patients in Bahrain / Mahmood Al Saeed;Mahmood Alawainati;Barrak Al Mousawi;Mohammed Al Barni;Fadhel Abbas;Aysha A. Sarwani
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Time for a do-not-resuscitate policy? outcomes of inpatient cardiopulmonary resuscitation in very old patients in Bahrain / Mahmood Al Saeed;Mahmood Alawainati;Barrak Al Mousawi;Mohammed Al Barni;Fadhel Abbas;Aysha A. Sarwani

Tác giả : Mahmood Al Saeed;Mahmood Alawainati;Barrak Al Mousawi;Mohammed Al Barni;Fadhel Abbas;Aysha A. Sarwani

Nhà xuất bản : World Health Organization. Regional Office for the Eastern Mediterranean

Năm xuất bản : 2022

Chủ đề : 1. Cardiopulmonary Resuscitation -- therapy. 2. Cardiovascular Diseases. 3. Family Practice. 4. Heart Arrest. 5. Hospital Mortality. 6. Retrospective Studies. 7. Survival Rate. 8. Tertiary Care Centers. 9. Journal / periodical articles.

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Background: Globally, do-not-resuscitate orders have been used for many years. Due to the lack of a do-not-resuscitate policy, full resuscitative measures including cardiopulmonary resuscitation (CPR) are applied for all patients admitted to our institution regardless of prognosis. Aims: To observe the outcomes of very old patients who underwent CPR, including mortality rate and length of stay. This will allow discussion of the need to implement a do-not-resuscitate policy in Bahrain, and its associated challenges. Methods: This was a retrospective observational study conducted in a 1200-bed tertiary hospital in Bahrain. We included patients aged ≥ 80 years admitted under general medicine who underwent CPR between January and July 2018. Medical records were reviewed for patients’ characteristics and outcomes. Results: Ninety patients were included in the study with an average age of 87.91 (6.27) years. The inhospital mortality rate was 96.67%, and 57.78% of patients died immediately after the first CPR attempt and 38.89% died during subsequent attempts. The survival rate at 1-year follow-up was only 1.11%. Conclusion: Survival of very old patients after cardiopulmonary arrest is low, and survival at discharge is even lower. The increase in the very old population will lead to a higher demand for critical care resources given the absence of a do-not-resuscitate policy. Our results demonstrate that implementing such a policy at our institution is crucial to reduce the number of futile CPR attempts, minimizing patients’ suffering, and optimizing resource allocation.
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https://iris.who.int/handle/10665/368764