title: Prevalence of patients with do-not-resuscitate status on acute geriatric wards in Flanders, Belgium.
abstract: BACKGROUND
  Elderly hospitalized patients have low survival rates after cardiopulmonary resuscitation, especially in the long term. This study aims to investigate the prevalence of patients with do-not-resuscitate (DNR) status on acute geriatric wards and the characteristics of the preceding decision-making process.
  
  
  METHODS
  On all 94 geriatric wards in Flanders, Belgium (2002), the geriatrician who performed the bulk of clinical work was asked to fill in a retrospective structured mail questionnaire.
  
  
  RESULTS
  The response rate was 72.3%. A DNR status was attributed to 20.3% of patients. A significant higher prevalence of patients with DNR status was found on wards with a geriatrician who had been active in patient care for 15 years or less and on wards with a DNR policy. Mostly, DNR status was attributed when the patient's condition declined (34.0%) or became critical (29.0%). Geriatricians consulted at least one person in 81.0% of the cases: (head) nurses in 72.2%, next of kin in 61.9%, the patient's general practitioner in 22.6%, and the patient him- or herself in 15.7%. Reasons stated to make a DNR decision were the prognosis (68.1%) and the physical condition of the patient (62.2%). Age was mentioned in only 21.1% of the cases, always in combination with other reasons.
  
  
  CONCLUSIONS
  One fifth of patients on acute geriatric wards in Flanders have DNR status. The decision to attribute DNR status is most often made late in the course of the disease. (Head) nurses and the patient's next of kin are often consulted, the patient and his or her general practitioner rarely.
authors: End-of-Life Care Research Group, Vrije Universiteit Brussel, Brussels, Belgium. cindy.de.gendt@vub.ac.be
authors: Cindy
authors: C
authors: De Gendt
authors: Johan
authors: J
authors: Bilsen
authors: Nele
authors: N
authors: Van Den Noortgate
authors: Margareta
authors: M
authors: Lambert
authors: Robert Vander
authors: RV
authors: Stichele
authors: Luc
authors: L
authors: Deliens
mesh_terms: D001530:Belgium; D003657:Decision Making; D005260:Female; D005853:Geriatrics / Q000706:statistics & numerical data*; D006757:Hospital Units / Q000706:statistics & numerical data*; D006761:Hospitals; D006801:Humans; D008297:Male; D016134:Organizational Policy; D016414:Resuscitation Orders; D012189:Retrospective Studies; D011795:Surveys and Questionnaires