Prevalence of patients with do-not-resuscitate status on acute geriatric wards in Flanders, Belgium

Cindy De Gendt; Johan Bilsen; Nele Van Den Noortgate; Margaretha Lambert; R. Vander Stichele; Luc Deliens

doi:10.1093/gerona/62.4.395

Prevalence of patients with do-not-resuscitate status on acute geriatric wards in Flanders, Belgium

Cindy De Gendt, Johan Bilsen, Nele Van Den Noortgate, Margaretha Lambert, R. Vander Stichele, Luc Deliens

Research output: Contribution to journal › Article › peer-review

9 Citations (Scopus)

Abstract

Background. Elderly hospitalized patients have low survival rates after cardiopulmonary resuscitation, especially in the long term. This study aims to investigate the prevalence of patients with do-not-resuscitate (DNR) status on acute geriatric wards and the characteristics of the preceding decision-making process.

Methods. On all 94 geriatric wards in Flanders, Belgium (2002), the geriatrician who performed the bulk of clinical work was asked to fill in a retrospective structured mail questionnaire.

Results. The response rate was 72.3%. A DNR status was attributed to 20.3% of patients. A significant higher prevalence of patients with DNR status was found on wards with a geriatrician who had been active in patient care for 15 years or less and on wards with a DNR policy. Mostly, DNR status was attributed when the patient's condition declined (34.0%) or became critical (29.0%). Geriatricians consulted at least one person in 81.0% of the cases: (head) nurses in 72.2%, next of kin in 61.9%, the patient's general practitioner in 22.6%, and the patient him- or herself in 15.7%. Reasons stated to make a DNR decision were the prognosis (68.1%) and the physical condition of the patient (62.2%). Age was mentioned in only 21.1% of the cases, always in combination with other reasons.

Conclusions. One fifth of patients on acute geriatric wards in Flanders have DNR status. The decision to attribute DNR status is most often made late in the course of the disease. (Head) nurses and the patient's next of kin are often consulted, the patient and his or her general practitioner rarely.

Original language	English
Pages (from-to)	395-400
Number of pages <span style="color:red"p> <font size="1.5"> ✽ </span> </font>	6
Journal	The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
Volume	62
Issue number	4
DOIs	https://doi.org/10.1093/gerona/62.4.395
Publication status	Published - 1 Apr 2007

Bibliographical note

Journals of Gerontology Series A-Biological Sciences and Medical Sciences. (in press)

Keywords

End of life care
geriatrics
do-not-resuscitate status

Access to Document

10.1093/gerona/62.4.395

OZR1517: End-of-life care for elderly patients
Deliens, L., Bilsen, J. & De Gendt, C.
1/10/06 → 30/09/07
Project: Fundamental
OZR1146: Advance care planning in nursing homes in Flanders, Belgium
Deliens, L., Bilsen, J. & De Gendt, C.
1/01/05 → 31/12/06
Project: Fundamental
GOA27: Dying well at the place of wish: a study of mortality statistics and the experiences of physicians, patients and families of deceased patients.
Bernheim, J. L., Deboosere, P., Distelmans, W., Bilsen, J., De Gendt, C., Deliens, L., Van den Block, L., Deschepper, R., Cohen, J. & Drieskens, K.
1/01/03 → 31/12/07
Project: Fundamental

Cite this

@article{6c69387b25d340e584e976b3eca5fe64,

title = "Prevalence of patients with do-not-resuscitate status on acute geriatric wards in Flanders, Belgium",

abstract = "Background. Elderly hospitalized patients have low survival rates after cardiopulmonary resuscitation, especially in the long term. This study aims to investigate the prevalence of patients with do-not-resuscitate (DNR) status on acute geriatric wards and the characteristics of the preceding decision-making process. Methods. On all 94 geriatric wards in Flanders, Belgium (2002), the geriatrician who performed the bulk of clinical work was asked to fill in a retrospective structured mail questionnaire. Results. The response rate was 72.3%. A DNR status was attributed to 20.3% of patients. A significant higher prevalence of patients with DNR status was found on wards with a geriatrician who had been active in patient care for 15 years or less and on wards with a DNR policy. Mostly, DNR status was attributed when the patient's condition declined (34.0%) or became critical (29.0%). Geriatricians consulted at least one person in 81.0% of the cases: (head) nurses in 72.2%, next of kin in 61.9%, the patient's general practitioner in 22.6%, and the patient him- or herself in 15.7%. Reasons stated to make a DNR decision were the prognosis (68.1%) and the physical condition of the patient (62.2%). Age was mentioned in only 21.1% of the cases, always in combination with other reasons. Conclusions. One fifth of patients on acute geriatric wards in Flanders have DNR status. The decision to attribute DNR status is most often made late in the course of the disease. (Head) nurses and the patient's next of kin are often consulted, the patient and his or her general practitioner rarely.",

keywords = "End of life care, geriatrics, do-not-resuscitate status",

author = "{De Gendt}, Cindy and Johan Bilsen and {Van Den Noortgate}, Nele and Margaretha Lambert and {Vander Stichele}, R. and Luc Deliens",

note = "Journals of Gerontology Series A-Biological Sciences and Medical Sciences. (in press)",

year = "2007",

month = apr,

day = "1",

doi = "10.1093/gerona/62.4.395",

language = "English",

volume = "62",

pages = "395--400",

journal = "The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences",

issn = "1079-5006",

publisher = "Oxford University Press",

number = "4",

}

Prevalence of patients with do-not-resuscitate status on acute geriatric wards in Flanders, Belgium. / De Gendt, Cindy; Bilsen, Johan; Van Den Noortgate, Nele; Lambert, Margaretha; Vander Stichele, R.; Deliens, Luc.

In: The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, Vol. 62, No. 4, 01.04.2007, p. 395-400.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Prevalence of patients with do-not-resuscitate status on acute geriatric wards in Flanders, Belgium

AU - De Gendt, Cindy

AU - Bilsen, Johan

AU - Van Den Noortgate, Nele

AU - Lambert, Margaretha

AU - Vander Stichele, R.

AU - Deliens, Luc

N1 - Journals of Gerontology Series A-Biological Sciences and Medical Sciences. (in press)

PY - 2007/4/1

Y1 - 2007/4/1

N2 - Background. Elderly hospitalized patients have low survival rates after cardiopulmonary resuscitation, especially in the long term. This study aims to investigate the prevalence of patients with do-not-resuscitate (DNR) status on acute geriatric wards and the characteristics of the preceding decision-making process. Methods. On all 94 geriatric wards in Flanders, Belgium (2002), the geriatrician who performed the bulk of clinical work was asked to fill in a retrospective structured mail questionnaire. Results. The response rate was 72.3%. A DNR status was attributed to 20.3% of patients. A significant higher prevalence of patients with DNR status was found on wards with a geriatrician who had been active in patient care for 15 years or less and on wards with a DNR policy. Mostly, DNR status was attributed when the patient's condition declined (34.0%) or became critical (29.0%). Geriatricians consulted at least one person in 81.0% of the cases: (head) nurses in 72.2%, next of kin in 61.9%, the patient's general practitioner in 22.6%, and the patient him- or herself in 15.7%. Reasons stated to make a DNR decision were the prognosis (68.1%) and the physical condition of the patient (62.2%). Age was mentioned in only 21.1% of the cases, always in combination with other reasons. Conclusions. One fifth of patients on acute geriatric wards in Flanders have DNR status. The decision to attribute DNR status is most often made late in the course of the disease. (Head) nurses and the patient's next of kin are often consulted, the patient and his or her general practitioner rarely.

AB - Background. Elderly hospitalized patients have low survival rates after cardiopulmonary resuscitation, especially in the long term. This study aims to investigate the prevalence of patients with do-not-resuscitate (DNR) status on acute geriatric wards and the characteristics of the preceding decision-making process. Methods. On all 94 geriatric wards in Flanders, Belgium (2002), the geriatrician who performed the bulk of clinical work was asked to fill in a retrospective structured mail questionnaire. Results. The response rate was 72.3%. A DNR status was attributed to 20.3% of patients. A significant higher prevalence of patients with DNR status was found on wards with a geriatrician who had been active in patient care for 15 years or less and on wards with a DNR policy. Mostly, DNR status was attributed when the patient's condition declined (34.0%) or became critical (29.0%). Geriatricians consulted at least one person in 81.0% of the cases: (head) nurses in 72.2%, next of kin in 61.9%, the patient's general practitioner in 22.6%, and the patient him- or herself in 15.7%. Reasons stated to make a DNR decision were the prognosis (68.1%) and the physical condition of the patient (62.2%). Age was mentioned in only 21.1% of the cases, always in combination with other reasons. Conclusions. One fifth of patients on acute geriatric wards in Flanders have DNR status. The decision to attribute DNR status is most often made late in the course of the disease. (Head) nurses and the patient's next of kin are often consulted, the patient and his or her general practitioner rarely.

KW - End of life care

KW - geriatrics

KW - do-not-resuscitate status

U2 - 10.1093/gerona/62.4.395

DO - 10.1093/gerona/62.4.395

M3 - Article

VL - 62

SP - 395

EP - 400

JO - The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences

JF - The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences

SN - 1079-5006

IS - 4

ER -

Prevalence of patients with do-not-resuscitate status on acute geriatric wards in Flanders, Belgium

Abstract

Bibliographical note

Keywords

Access to Document

Fingerprint

Projects

OZR1517: End-of-life care for elderly patients

OZR1146: Advance care planning in nursing homes in Flanders, Belgium

GOA27: Dying well at the place of wish: a study of mortality statistics and the experiences of physicians, patients and families of deceased patients.

Cite this