The do-not-resuscitate order: incidence of documentation in the medical records of cancer patients referred for palliative radiotherapy
2006

Do-Not-Resuscitate Orders in Cancer Patients

Sample size: 209 publication Evidence: low

Author Information

Author(s): Bradley N.M.E. BSc(C), Sinclair E. BSc MRT(T), Danjoux C. MD, Barnes E.A. MD, Tsao M.N. MD, Farhadian M. RN, Yee A. MD MSc, Chow E. MBBS MSc

Primary Institution: Toronto–Sunnybrook Regional Cancer Centre, University of Toronto

Hypothesis

What is the incidence of documentation of do-not-resuscitate orders in cancer patients referred for palliative radiotherapy?

Conclusion

Only a small proportion of cancer patients referred for outpatient palliative radiotherapy had documentation of their do-not-resuscitate code status.

Supporting Evidence

  • Only 13 (6.2%) of the 209 patients had any documented reference to CPR code status.
  • Patients with documented status were significantly older and had poorer performance status.
  • 69% of patients with documented CPR code status were referred hospital inpatients.

Takeaway

Most cancer patients don't have clear instructions about whether they want to be resuscitated if they have a medical emergency, which can lead to confusion and unnecessary treatments.

Methodology

Reviewed referral notes and medical records for 209 consecutive patients seen in the clinics for documentation of CPR-related advance directives.

Limitations

The study had a small sample size of patients with documented CPR advance directives.

Participant Demographics

Patients had a median age of 70 years, with a roughly equal distribution of men and women.

Statistical Information

P-Value

p = 0.0347

Statistical Significance

p<0.05

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