Korean J Hosp Palliat Care.  2017 Jun;20(2):93-99. 10.14475/kjhpc.2017.20.2.93.

Changes in Life-sustaining Treatment in Terminally Ill Cancer Patients after Signing a Do-Not-Resuscitate Order

• Kim HA
• Park JY

• KMID: 2380010
• DOI: http://doi.org/10.14475/kjhpc.2017.20.2.93

Abstract

PURPOSE
This study investigated changes in life-sustaining treatments in terminally ill cancer patients after consenting to a do-not-resuscitate (DNR) order.
METHODS
Electronic medical records were reviewed to select terminally ill cancer patients who were treated at the oncology unit of the Asan Medical Center, a tertiary hospital in South Korea and died between January 1, 2013 and December 31, 2013.
RESULTS
The median (range) age of the 200 patients was 59 (22~89) years, and 62% (124 persons) were male. Among all patients, 83.5% were aware of their medical condition, and 47.0% of the patients had their DNR order signed by their spouses. The median of the patients' hospital stay was 15 days, and time from admission to DNR decision was 10 days. After signing a DNR order, 35.7~100% of the life-sustaining treatments that had been provided at the time of the DNR decision making were administered. The most commonly discontinued interventions were transfusion (13.5%), blood test (11.5%) and parenteral nutrition (8.5%).
CONCLUSION
It is necessary to define the scope of life-sustaining treatments for DNR patients. Treatment guidelines should be established as well to secure terminal patients' death with dignity after their consent to a DNR order, thereby avoiding meaningless life-sustaining treatments and allowing administration of active terminal care interventions.

Keyword

Terminally ill; Life support care; Neoplasms; Resuscitation orders; Hospice care

MeSH Terms

Chungcheongnam-do
Decision Making
Electronic Health Records
Hematologic Tests
Hospice Care
Humans
Korea
Length of Stay
Life Support Care
Male
Parenteral Nutrition
Resuscitation Orders*
Right to Die
Spouses
Terminal Care
Terminally Ill*
Tertiary Care Centers