Resuscitation orders demonstrate differences by gender, stroke type and intervention

J Stroke Cerebrovasc Dis. 2024 Sep;33(9):107881. doi: 10.1016/j.jstrokecerebrovasdis.2024.107881. Epub 2024 Jul 20.

Abstract

Background and purpose: Resuscitation orders describe individual preferences and types of intervention, such as suitability for cardiopulmonary resuscitation (CPR), that may provide benefit in the event of critical deterioration. The purpose of this study was to examine stroke inpatient resuscitation order completion and content.

Methods: This retrospective cohort study examined resuscitation orders in consecutive individuals admitted to a tertiary stroke centre over a 21-month period. Multivariable logistic regression was used to identify factors associated with resuscitation order completion and content.

Results: 1924 individuals were included in the study. The proportion of individuals who had resuscitation orders completed was 37.4%. Several factors were associated with an increased likelihood of resuscitation order completion including having received endovascular thrombectomy (p=0.013) and having intracerebral haemorrhage (p=0.001). Females were more likely to have a resuscitation order that is not for CPR (p=0.021, OR 95%CI 1.080-2.542). Patients with intracerebral haemorrhage were also more likely to be not for CPR (p=0.037, OR 95%CI 1.039-3.353).

Conclusions: Disparities exist in resuscitation order completion and content based on demographic and stroke characteristics. Further research is required to identify the reasons for these differences and to optimise resuscitation order completion.

Keywords: Advanced care planning; Cardiopulmonary resuscitation; Communication; Gender; Palliative care.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cardiopulmonary Resuscitation*
  • Cerebral Hemorrhage / therapy
  • Endovascular Procedures / adverse effects
  • Female
  • Healthcare Disparities
  • Humans
  • Inpatients
  • Male
  • Middle Aged
  • Resuscitation Orders*
  • Retrospective Studies
  • Risk Factors
  • Sex Factors
  • Stroke* / diagnosis
  • Stroke* / therapy
  • Thrombectomy / adverse effects