Determinant factors of mortality in terminally ill patients with do-not-resuscitate orders

Abstract

Background: This study aimed to profile the clinical pictures and identify the risk factors of mortality among terminally ill patients who visited the emergency department (ED) and had signed do-not-resuscitate (DNR) consents. Methods: This prospective study employed purposeful sampling of 200 adult, nontrauma, terminally ill patients who visited the ED and signed a DNR consent between July 1, 2011, and March 31, 2012. Physiological variables were compared between fatal and survival patients using Student's t-tests after assessing the normality of the data distribution. Results: The Cox proportional regression analysis revealed that patients taking antiarrhythmic drugs and vasopressor had a 47.6-fold and 2.8-fold higher mortality, respectively, compared to nonusers and those who had a respiratory rate ≥28 breaths/min showed a 2.8-fold increase in their risk of death compared to those with a respiratory rate <28 breaths/min. Conclusions: Among terminally ill patients who had signed a DNR consent at the ED, significantly higher hazard ratios of mortality were observed in patients who were on antiarrhythmic drugs or vasopressor, had respiratory rates ≥28 breaths/min, had been intubated, and had serum potassium levels ≥ 4.5 mEq/L.

Keywords

• Do-not-resuscitate
• mortality
• terminally ill patients