The impact of do-not-resuscitate order on triage decisions to a medical intensive care unit

被引：62

作者：

Cohen, Rubin I. ^{[1
]}

Lisker, Gita N. ^{[1
]}

Eichorn, Ann ^{[2
]}

Multz, Alan S. ^{[1
]}

Silver, Alan ^{[2
]}

机构：

[1] Albert Einstein Coll Med, Div Pulm Crit Care & Sleep Med, Long Isl Jewish Med Ctr, New Hyde Pk, NY 11044 USA

[2] N Shore Long Isl Jewish Hlth Syst, Krasnoff Qual Management Inst, Great Neck, NY USA

来源：

JOURNAL OF CRITICAL CARE | 2009年 / 24卷 / 02期

关键词：

Do-not-resuscitate order; Triage decisions; Medical intensive care unit; PATIENTS REFUSED ADMISSION; RATIONING CRITICAL-CARE; CRITICALLY-ILL PATIENTS; BEDS; ICU;

D O I：

10.1016/j.jcrc.2008.01.007

中图分类号：

R4 [临床医学];

学科分类号：

100218 [急诊医学];

摘要：

Purpose: To determine whether the presence of a do-not-resuscitate (DNR) order impacts on triage decisions to a medical intensive care unit (MICU) of an academic medical center. Methods: Data were collected on 179 patients in whom MICU consultation was sought and included demographic, clinical information, diagnoses, ICU admission decision, Acute Physiological and Chronic Health Evaluation II (APACHE II) score, and the presence of DNR order. Functional status was determined retrospectively using the Modified Rankin Score. Results: The only factor that influenced MICU admission was the presence of DNR order at the time of MICU consultation (odds ratio, 0.25; 95% confidence interval, 0.09-0.71, P < .006). There was no difference between the age, APACHE II scores, or functional status between admitted or refused. Medical intensive care unit admission was associated with increased length of stay without difference in mortality. Conclusion: The presence of a DNR order at the time of MICU consultation was significantly associated with the decision to refuse a patient to the MICU. (C) 2009 Elsevier Inc. All rights reserved.

引用

页码：311 / 315

页数：5

共 23 条

[1]

Compliance with triage to intensive care recommendations [J].