Abstract 20005: Cardiac Patients Risk Resuscitation Attempts Against Their Will Due to Lack of Do-Not-Resuscitate Conversations During Hospitalization

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Introduction: The decision to withhold resuscitation lies with the physician, but patients have the right to decline resuscitation. Many studies have shown that health professionals find Do-Not-Resuscitate (DNR) orders difficult to address, and conversations on DNR do often not take place.

Currently, we only have very limited knowledge about the patient perspective on DNR.

Aim: To investigate cardiac patients’ perspective on DNR orders and conversation on resuscitation.

Methods: Questionnaires were distributed to patients admitted to departments of cardiology in three community hospitals in Denmark inquiring on patient demographics, activities of daily living, knowledge on resuscitation, their attitude towards resuscitation and how the patient would like a DNR conversation to take place.

Results: A total of 250 patients (response rate: 87%; median age (Q1;Q3): 71 (60,81), female: 39%) were included. Overall, 82% had decided if they wanted resuscitation attempted or not. The majority, 139 (56%), wanted resuscitation to be attempted, while 65 (26%) did not wish resuscitation. Patients who did not wish resuscitation were older (p<0.001), more restricted in activities of daily living (p=0.002) and had lower quality of life (p=0.005) compared to participants who wanted resuscitation. Only 10 (4%) out of 250 patients had a DNR conversation during the current hospitalization. Half of patients (44%) wished a DNR decision to be taken jointly with a physician, and half (45%) believed that a DNR conversation should be restricted to hospitalizations due to life threatening disease.

Conclusion: The majority of cardiac patients have decided if they want resuscitation to be attempted. One fourth of patients wished a DNR order, but only very few had a DNR conversation during hospitalization risking resuscitation against their will. Patients thought that a DNR conversation should be taken jointly with a physician, but only in case of life threatening disease.

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