Resuscitation choices change over time in heart failure

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."

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

Related Stories

Recommended for you

Catheterization increasing for seniors with STEMI

date 14 hours ago

(HealthDay)—From 1999 to 2009 there was a decrease in the proportion of older adults with ST-segment elevation acute myocardial infarction (STEMI) who did not undergo cardiac catheterization, according ...

Race influences warfarin dose, study says

date 22 hours ago

A new report demonstrates that clinical and genetic factors affecting dose requirements for warfarin vary by race. The study, published online today in Blood, the Journal of the American Society of Hematology (ASH), propose ...

Even moderate BMI reduction could ease A-fib burden

date May 29, 2015

(HealthDay)—Incremental increases in body mass index (BMI) are associated with excess risk of incident, postoperative, and post-ablation atrial fibrillation (AF), according to a review published online ...

Personalized saline may provide solution to heart death

date May 29, 2015

Saline solution is a staple of every hospital. No matter the ailment, doctors have known for more than a century that saline is key to keeping patients hydrated and maintaining their blood pressure levels. ...

User comments

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.