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BMC Palliat Care. 2019;18(1):93.

Identification of a potentially avoidable cardiopulmonary resuscitation in hematology and oncology wards.

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제1저자 최연주 · 교신저자 김진원

소속 (5)
  1. Division of Hematology and Medical Oncology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82 Gumi-ro 173 beon-gil, Bundang-gu, Seongnam, 13620, Republic of Korea.
  2. Division of Hematology and Medical Oncology, Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.
  3. Present Address: Department of Investigational Cancer Therapeutics, The MD Anderson Cancer Center, Houston, TX, USA.
  4. Division of Hematology and Medical Oncology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82 Gumi-ro 173 beon-gil, Bundang-gu, Seongnam, 13620, Republic of Korea. jwkim@snubh.org.
  5. Present Address: CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea.

Abstract

BACKGROUND In-hospital cardiopulmonary resuscitation (CPR) is one of undesirable situations. We tried to identify and characterize a potentially avoidable CPR in cancer patients who were hospitalized in hematology and oncology wards.

METHODS A potentially avoidable CPR was determined based on chemotherapy setting, disease status and clinical situation at the time when a cardiopulmonary arrest occurred, by using a consensus-driven medical records review of two physicians.

RESULTS One hundred thirty-seven patients among 12,437 patients hospitalized at hematology and oncology wards between March 2003 and June 2015 (1.1%) underwent a CPR. Eighty-eight patients (64.2%) were men. The majority of patients with a CPR had lung cancer (41, 29.9%), hematologic malignancy (24, 17.5%), stomach cancer (23, 16.8%) or lymphoma (20, 14.6%). A potentially avoidable CPR was identified in 51 patients (37.2%). In a multivariate analysis, advanced diseases and certain tumor types (e.g., lung cancer, lymphoma) were significant risk factors for a potentially avoidable CPR. Of patients who received a potentially avoidable CPR, 29 patients (56.9%) did not have a do-not-resuscitate documentation. A first return of spontaneous circulation rate (ROSC) and in-hospital survival rate (IHSR) were much lower in patients with a potentially avoidable CPR than those with a CPR that was not avoidable (ROSC: 39.2% vs 53.5%, P = 0.106; IHSR: 2.0% vs 12.8%, P = 0.032, respectively).

CONCLUSIONS A potentially avoidable CPR was common at hematology and oncology wards. A potentially avoidable CPR frequently occurred in advanced diseases and certain tumor types. Furthermore, cancer patients who received a potentially avoidable CPR showed the worse prognosis.

Keywords

CancerCardiopulmonary arrestPotentially avoidablePrognosisResuscitation

Figures

Fig. 1
Fig. 1 Outcomes of resuscitation attempts. CPR, cardiopulmonary resuscitation; ROSC, return of spontaneous circulation

그림 출처: PubMed Central 공개 논문 (PMC6829942)

Conflict of interest statement

The authors declare that they have no competing interest.

그 밖의 정보
출판 형태
Journal Article
저널
BMC palliative care · eISSN 1472-684X
전자 출판
2019-11-04
MeSH
Aged · Aged, 80 and over · Cardiopulmonary Resuscitation / statistics & numerical data · Female · Health Status · Heart Arrest / etiology / therapy · Hematologic Neoplasms / complications · Hospice Care · Hospital Mortality · Hospitals / statistics & numerical data · Humans · Male · Middle Aged · Neoplasms / complications · Republic of Korea · Resuscitation Orders · Risk Factors · Sex Factors
참고문헌
19편