Documentation of Do-Not-Attempt-Cardiopulmonary-Resuscitation orders amid the COVID-19 pandemic.

Content Provider	Europe PMC
Author	Connellan, D Diffley, K McCabe, J Cotter, A McGinty, T Sheehan, G Ryan, K Cullen, W Lambert, J S Callaly, E L Kyne, L
Copyright Year	2021
Abstract	AbstractIntroduction: The COVID-19 pandemic has brought the decision-making process regarding cardiopulmonary resuscitation (CPR) into focus. The aim of this study is to compare rates of Do-Not-Attempt CPR (DNACPR) documentation in older hospitalised patients before and during the COVID-19 pandemic.Methods: This was a retrospective repeated cross-sectional study. Data including co-morbidities and resuscitation status was collected on 300 patients with COVID-19 hospitalised from March 1st to May 31s t 2020. DNACPR documentation rates in patients aged ≥65 years with a diagnosis of COVID-19 were compared to those without COVID-19 admitted during the same period and also compared to documentation rates pre-COVID-19 pandemic (March 1st to May 31s t 2019).Results: Of 300 COVID-19-positive patients, 28% had a DNACPR order documented during their admission. Of 131 older (≥65 years) patients with COVID-19, 60.3% had a DNACPR order compared to 25.4% of 130 older patients without COVID-19 (p < 0.0001). During a comparable time period pre-pandemic, 15.4% of 130 older patients had a DNACPR order in place (p < 0.0001). Fifty percent of DNACPR orders were recorded within 24 hours of a positive swab result for SARS-CoV-2. Of older COVID-19-positive patients, 39.2% were referred to palliative care services and 70.2% survived.Conclusion: The COVID-19 pandemic has prompted more widespread and earlier decision-making regarding resuscitation status. Although case-fatality-rates were higher for older hospitalised patients with COVID-19, many older patients survived the illness. Advance care planning should be prioritised in all patients and should remain good clinical practice despite the pandemic.
Related Links	https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC8135469&blobtype=pdf
Page Count	11
ISSN	00020729
Journal	Age and Ageing [Age Ageing]
Volume Number	50
DOI	10.1093/ageing/afab075
PubMed Central reference number	PMC8135469
Issue Number	4
PubMed reference number	33909020
e-ISSN	14682834
Language	English
Publisher	Oxford University Press
Publisher Date	2021-06-01
Access Restriction	Open
Rights License	This article is made available via the PMC Open Access Subset for unrestricted re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the COVID-19 pandemic or until permissions are revoked in writing. Upon expiration of these permissions, PMC is granted a perpetual license to make this article available via PMC and Europe PMC, consistent with existing copyright protections. © The Author(s) 2021. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.
Subject Keyword	Do-not-attempt-cardiopulmonary-resuscitation orders COVID-19 older people palliative care
Content Type	Text
Resource Type	Article
Subject	Aging Geriatrics and Gerontology