Process of care and mortality of stroke patients with and without a do not resuscitate order in the West Midlands, UK
| Autor: | Andrew Stevens, Shakir Hussain, Jonathan Mant, Mohammed A Mohammed, Louise Bentham |
|---|---|
| Rok vydání: | 2005 |
| Předmět: |
Pediatrics
medicine.medical_specialty Do Not Resuscitate Order Health Services Accessibility Case mix index Health care medicine Humans Stroke Diagnosis-Related Groups Aged Resuscitation Orders Aged 80 and over Patient Care Team Medical Audit Aspirin Hospitals Public business.industry Health Policy Do not resuscitate Age Factors Stroke Rehabilitation Public Health Environmental and Occupational Health General Medicine Process of care medicine.disease Triage Intensive Care Units Logistic Models Outcome and Process Assessment Health Care England Emergency medicine Physical Therapy Department Hospital business medicine.drug |
| Zdroj: | International Journal for Quality in Health Care. 18:102-106 |
| ISSN: | 1464-3677 1353-4505 |
| DOI: | 10.1093/intqhc/mzi081 |
| Popis: | Objectives. To compare the process of care of stroke patients with and without a do not resuscitate (DNR) order. Design. Retrospective case note review with prospective follow up of mortality. Setting. Seven acute hospitals, with stroke units, in the West Midlands, UK. Participants. A random sample of patients (n = 702) admitted to hospital with acute stroke over a twelve month period. Main outcome measures. Case mix and process of care measures derived from the intercollegiate stroke audit package. Thirty day and one year mortality. Results. About one-third (34%, 238/702) of stroke patients had DNR orders. The thirty-day mortality for DNR patients was 67% (160/238) versus 10% (46/449) for patients without DNR orders. DNR patients had significantly worse case-mix profile than non-DNR patients – median age 81 y vs 75y; fully conscious 36% vs 79%, able to walk 1% vs 21% and no loss of power in either arm 5% vs 24% (all p < 0.0001). DNR patients were more likely to be assessed early by a speech and language therapist (77% vs 59%, p < 0.001), but less likely to receive the majority of their care in a stroke/rehabilitation unit (20% vs 57%, p < 0.0001), or be cared for on a stroke unit or by a stroke team (42% vs 70%, p |
| Databáze: | OpenAIRE |
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