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Tytuł pozycji:

Advanced care planning during the COVID-19 pandemic: ceiling of care decisions and their implications for observational data

Tytuł :
Advanced care planning during the COVID-19 pandemic: ceiling of care decisions and their implications for observational data
Autorzy :
Sam Straw
Melanie McGinlay
Michael Drozd
Thomas A. Slater
Alice Cowley
Stephe Kamalathasan
Nicholas Maxwell
Rory A. Bird
Aaron O. Koshy
Milos Prica
Peysh A. Patel
Samuel D. Relton
John Gierula
Richard M. Cubbon
Mark T. Kearney
Klaus K. Witte
Pokaż więcej
Temat :
COVID-19
Resuscitation
Advanced care planning
Comorbidity
Elderly
Geriatrics
Special situations and conditions
RC952-1245
Źródło :
BMC Palliative Care, Vol 20, Iss 1, Pp 1-11 (2021)
Wydawca :
BMC, 2021.
Rok publikacji :
2021
Kolekcja :
LCC:Special situations and conditions
Typ dokumentu :
article
Opis pliku :
electronic resource
Język :
English
ISSN :
1472-684X
Relacje :
https://doaj.org/toc/1472-684X
DOI :
10.1186/s12904-021-00711-8
Dostęp URL :
https://doaj.org/article/161c31ca2806469daf7d61519a16d22f
Numer akcesji :
edsdoj.161c31ca2806469daf7d61519a16d22f
Czasopismo naukowe
Abstract Background Observational studies investigating risk factors in coronavirus disease 2019 (COVID-19) have not considered the confounding effects of advanced care planning, such that a valid picture of risk for elderly, frail and multi-morbid patients is unknown. We aimed to report ceiling of care and cardiopulmonary resuscitation (CPR) decisions and their association with demographic and clinical characteristics as well as outcomes during the COVID-19 pandemic. Methods Retrospective, observational study conducted between 5th March and 7th May 2020 of all hospitalised patients with COVID-19. Ceiling of care and CPR decisions were documented using the Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) process. Unadjusted and multivariable regression analyses were used to determine factors associated with ceiling of care decisions and death during hospitalisation. Results A total of 485 patients were included, of whom 409 (84·3%) had a documented ceiling of care; level one for 208 (50·9%), level two for 75 (18·3%) and level three for 126 (30·8%). CPR decisions were documented for 451 (93·0%) of whom 336 (74·5%) were ‘not for resuscitation’. Advanced age, frailty, White-European ethnicity, a diagnosis of any co-morbidity and receipt of cardiovascular medications were associated with ceiling of care decisions. In a multivariable model only advanced age (odds 0·89, 0·86–0·93 p
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