Resuscitation choices change over time in heart failure

May 21, 2014
Resuscitation choices change over time in heart failure

(HealthDay)—For patients with heart failure, resuscitation preferences seem to change over time and are influenced by advancing age and comorbidity, according to a study published online May 13 in Circulation: Cardiovascular Quality and Outcomes.

Shannon M. Dunlay, M.D., from the Mayo Clinic in Rochester, Minn., and colleagues examined resuscitation preferences for 608 Southeastern Minnesota residents with heart failure, enrolled into a longitudinal study from October 2007 through September 2011. Information on resuscitation preferences was extracted from medical records.

The researchers found that 237 of the patients died during follow-up. Most patients (73.4 percent) were Full Code at enrollment, while 78.5 percent were do-not-resuscitate (DNR) at death. Advanced age, chronic , previous malignancy, and decreased mobility were identified as independent predictors of DNR status at enrollment. The risk of death was increased for patients who were DNR (unadjusted hazard ratio, 2.03; P < 0.001), but after adjustment for age, comorbidity, and self-perceived general health, the risk did not persist (hazard ratio, 0.97; P = 0.83). Only 4.6 percent of the 481 patients who were Full Code during follow-up received for an in-hospital cardiac arrest. Of these patients, eight survived to discharge, and only two made a complete recovery and returned home. There was a median of 37 days from final decision to be DNR until death.

"The resuscitation preferences of with seem to be driven by the decline in clinical status that often accompanies advanced age and multimorbidity," the authors write. "Furthermore, these data suggest that electing DNR status does not independently affect a patient's risk of death."

Explore further: Do-not-resuscitate orders associated with poor surgical outcomes even for non-emergency procedures

More information: Abstract
Full Text (subscription or payment may be required)

Related Stories

Considerable sudden death in hypertrophic cardiomyopathy

April 22, 2014

(HealthDay)—Patients with hypertrophic cardiomyopathy (HC) without traditional risk factors and with no or mild symptoms have a considerable rate of sudden cardiac death, according to a study published in the May 1 issue ...

Recommended for you

What powers the pumping heart?

September 25, 2015

Researchers at the Ted Rogers Centre for Heart Research have uncovered a treasure trove of proteins, which hold answers about how our heart pumps—a phenomenon known as contractility.

Sticky gel helps stem cells heal rat hearts

September 24, 2015

A sticky, protein-rich gel created by Johns Hopkins researchers appears to help stem cells stay on or in rat hearts and restore their metabolism after transplantation, improving cardiac function after simulated heart attacks, ...


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.