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KMID : 0856920160190010026
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Journal of Hospice and Palliative Care
2016 Volume.19 No. 1 p.26 ~ p.33
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Clinical Characteristics of Oncologic Patients with DNR Decision at a Tertiary Hospital
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강나영:Kang Na-Young
박정윤:Park Jeong-Yun
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Abstract
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Purpose: This study was conducted to identify clinical characteristics of oncologic patients at a point when they signed their do-not-resuscitate (DNR) orders.
Methods: From January through December 2014, we retrospectively analyzed the records of 197 patients who passed away after agreeing to a DNR order in the hemato-oncology department of a tertiary hospital.
Results: Of all, 121 patients (61.4%) were male and 76 (38.6%) were female, and their average age was 58.7 years. Ninety-four patients (47.7%) had gastrointestinal cancer. The ECOG performance status at admission was grade 3 in 76 patients (36.5%) and grade 4 in 11 (5.6%). The patients’ mean hospital stay was 20 days. The mean duration from the admission to DNR decision was 13 days, and the mean duration from DNR decision to death was seven days.
Conclusion: Study results indicate that a decision on signing or refusing a DNR order was made by medical staff mostly based on the opinions of patients’ guardians rather than the patients themselves. This suggests that patients’ own wishes are not well respected. Thus, it is urgent to establish institutional devices to enhance cancer patients’ autonomy regarding DNR and to define an adequate timing for withdrawal of treatments.
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KEYWORD
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Terminally ill, Neoplasms, Resuscitation orders, Terminal care, Hospice care
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