Your browser doesn't support javascript.
loading
Early Versus Late DNR Orders and its Predictors in a Saudi Arabian ICU: A Descriptive Study.
Aletreby, Waleed Tharwat; Mady, Ahmed F; Al-Odat, Mohammed A; Balshi, Ahmed N; Mady, Anas A; Al-Odat, Adam M; Elshayeb, Amira M; Mostafa, Ahmed F; Abd Elsalam, Shereen A; Odchigue, Kriz L.
Afiliación
  • Aletreby WT; Department of Critical Care, King Saud Medical City, Riyadh, Saudi Arabia.
  • Mady AF; Department of Critical Care, King Saud Medical City, Riyadh, Saudi Arabia.
  • Al-Odat MA; Department of Anesthesia, Faculty of Medicine, Tanta University, Tanta, Egypt.
  • Balshi AN; Department of Critical Care, King Saud Medical City, Riyadh, Saudi Arabia.
  • Mady AA; Department of Critical Care, King Saud Medical City, Riyadh, Saudi Arabia.
  • Al-Odat AM; Department of College of Medicine, Al-Faisal University, Riyadh, Saudi Arabia.
  • Elshayeb AM; College of Medicine, Jordanian University of Science and Technology, Amman, Jordan.
  • Mostafa AF; Department of Critical Care, King Saud Medical City, Riyadh, Saudi Arabia.
  • Abd Elsalam SA; Department of Critical Care, King Saud Medical City, Riyadh, Saudi Arabia.
  • Odchigue KL; Department of Internal Medicine, King Salman Hospital, Riyadh, Saudi Arabia.
Saudi J Med Med Sci ; 10(3): 192-197, 2022.
Article en En | MEDLINE | ID: mdl-36247060
Background: Practices of Do-Not-Resuscitate (DNR) orders show discrepancies worldwide, but there are only few such studies from Saudi Arabia. Objective: To describe the practice of DNR orders in a Saudi Arabian tertiary care ICU. Methods: This retrospective study included all patients who died with a DNR order at the ICU of King Saud Medical City, Riyadh, Saudi Arabia, between January 1 to December 31, 2021. The percentage of early DNR (i.e., ≤48 hours of ICU admission) and late DNR (>48 hours) orders were determined and the variables between the two groups were compared. The determinants of late DNR were also investigated. Results: A total of 723 cases met the inclusion criteria, representing 14.9% of all ICU discharges and 63% of all ICU deaths during the study period. The late DNR group comprised the majority of the cases (78.3%), and included significantly more patients with acute respiratory distress syndrome (ARDS), community acquired pneumonia (CAP), acute kidney injury, and COVID-19, and significantly fewer cases of readmissions and malignancies. Septic shock lowered the odds of a late DNR (OR = 0.4, 95% CI: 0.2-0.9;P= 0.02), while ARDS (OR = 3.3, 95% CI: 2-5.4;P < 0.001), ischemic stroke (OR = 2.5, 95% CI: 1.1-5.4;P= 0.02), and CAP (OR = 2, 95% CI: 1.3-3.1;P= 0.003) increased the odds of a late DNR. Conclusion: There was a higher frequency of late DNR orders in our study compared to those reported in several studies worldwide. Cases with potential for a favorable outcome were more likely to have a late DNR order, while those with expected poorer outcomes were more likely to have an early DNR order. The discrepancies highlight the need for clearer guidelines to achieve consistency.
Palabras clave
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Guideline / Observational_studies / Prognostic_studies / Risk_factors_studies Idioma: En Revista: Saudi J Med Med Sci Año: 2022 Tipo del documento: Article País de afiliación: Arabia Saudita Pais de publicación: India
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Guideline / Observational_studies / Prognostic_studies / Risk_factors_studies Idioma: En Revista: Saudi J Med Med Sci Año: 2022 Tipo del documento: Article País de afiliación: Arabia Saudita Pais de publicación: India