Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Dec 20:2023:2771149.
doi: 10.1155/2023/2771149. eCollection 2023.

Do-Not-ResuscitateDecision-Making during the COVID-19 Pandemic in a Teaching Hospital: Lessons Learned for the Future

Mick van de Wiel  1 , Sabrina van Ierssel  2 , Walter Verbrugghe  3 , Veerle Mertens  4 , Annelies Janssens  1
Affiliations

Do-Not-ResuscitateDecision-Making during the COVID-19 Pandemic in a Teaching Hospital: Lessons Learned for the Future

Mick van de Wiel et al. J Aging Res. .

Abstract

Method: A cross-sectional survey study was conducted between February 2021 and April 2021 for all doctors and doctors in training, working in the Antwerp University Hospital during the COVID-19 pandemic.

Results: 127 doctors participated in this study. The familiarity with the different scores used in the triage during the COVID-10 pandemic was 51% for the Clinical Frailty Scale (CFS) and 20% for the Charlson Comorbidity Index (CCI). Participants indicated that their DNR decision is based on various aspects such as clinical assessment, comorbidities, patient's wishes, age, prognosis, and functional state.

Conclusion: The familiarity with the different scores used during triage assessments is low. The total clinical picture of the patient is needed to make a considered decision, and this total picture of the patient seems to be well encompassed by frailty measurement (CFS). Although many participants indicated that the different scores do not offer much added value compared to their clinical assessment, it can help guide DNR decisions, especially for doctors in training.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Figure 1
Figure 1
Most frequently cited responses to the question, “What do you base your decision-making on when determining a DNR code?”
See this image and copyright information in PMC

References

    1. Richardson S., Hirsch J. S., Narasimhan M., et al. Presenting characteristics, comorbidities, and outcomes among 5700 patients hospitalized with COVID-19 in the New York city area. JAMA . 2020;323(20):p. 2052. doi: 10.1001/jama.2020.6775. - DOI - PMC - PubMed
    1. Onder G., Rezza G., Brusaferro S. Case-fatality rate and characteristics of patients dying in relation to COVID-19 in Italy. JAMA . 2020;323(18):1775–1776. doi: 10.1001/jama.2020.4683. - DOI - PubMed
    1. Borasio G. D., Gamondi C., Obrist M., Jox R. COVID-19: decision making and palliative care. Swiss Medical Weekly . 2020;150 doi: 10.4414/smw.2020.20233.w20233 - DOI - PubMed
    1. Curtis J. R., Kross E. K., Stapleton R. D. The importance of addressing advance care planning and decisions about do-not-resuscitate orders during novel coronavirus 2019 (COVID-19) JAMA . 2020;323(18):1771–1772. doi: 10.1001/jama.2020.4894. - DOI - PubMed
    1. Detering K., Silvester W., Corke C., et al. Teaching general practitioners and doctors-in-training to discuss advance care planning: evaluation of a brief multimodality education programme. BMJ Supportive & Palliative Care . 2014;4(3):313–321. doi: 10.1136/bmjspcare-2013-000450. - DOI - PubMed

LinkOut - more resources