title: The Relation Between the Timing of Palliative Care and the Frequency and Timing of Do-Not-Resuscitate Orders Among Cancer Deaths in a Tertiary Care Hospital.
abstract: The medical records of 246 in-hospital cancer deaths were reviewed to explore the relation between palliative care (PC) timing and the frequency and timing of do-not-resuscitate (DNR) designation. The rate of DNR designation was 100% in patients referred to PC and 82% in those never referred (P < .001). Patients were grouped into 4 groups: early PC (>90 days from PC referral to death), intermediate PC (>30-90 days), late PC (≤30 days), and no PC. The median DNR to death time was 96, 41, 11, and 3 days, respectively (P < .001). The proportion of intensive care unit (ICU) deaths was 0%, 1%, 3%, and 27%, respectively (P < .001). In conclusion, in a tertiary care hospital, earlier PC was associated with earlier DNR designation and less frequent ICU deaths among in-hospital cancer deaths.
authors.affiliation: Oncology Center, King Abdullah Medical City-Holy Capital, Makkah, Saudi Arabia Palliative Medicine Unit, Kasr Al-Ainy Center of Clinical Oncology & Nuclear Medicine (NEMROCK), Kasr Al-Ainy School of Medicine, Cairo University, Cairo, Egypt alsirafy@kasralainy.edu.eg.
authors.forename: Samy A
authors.initials: SA
authors.lastname: Alsirafy
authors.affiliation: Oncology Center, King Abdullah Medical City-Holy Capital, Makkah, Saudi Arabia Medical Oncology Department, Faculty of medicine, Zagazig University, Sharkia, Egypt.
authors.forename: Amrallah A
authors.initials: AA
authors.lastname: Mohammed
authors.affiliation: Oncology Center, King Abdullah Medical City-Holy Capital, Makkah, Saudi Arabia.
authors.forename: Abdullah S
authors.initials: AS
authors.lastname: Al-Zahrani
authors.affiliation: Oncology Center, King Abdullah Medical City-Holy Capital, Makkah, Saudi Arabia Medical Oncology Department, Faculty of medicine, Zagazig University, Sharkia, Egypt.
authors.forename: Ahmad A
authors.initials: AA
authors.lastname: Raheem
authors.affiliation: Oncology Center, King Abdullah Medical City-Holy Capital, Makkah, Saudi Arabia Clinical Oncology Department, Kasr Al-Ainy Center of Clinical Oncology & Nuclear Medicine (NEMROCK), Kasr Al-Ainy School of Medicine, Cairo University, Cairo, Egypt.
authors.forename: Amr T
authors.initials: AT
authors.lastname: El-Kashif
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007362:Intensive Care Units / Q000458:organization & administration / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality*; D010166:Palliative Care / Q000458:organization & administration* / Q000706:statistics & numerical data; D000070659:Patient Comfort; D016414:Resuscitation Orders; D012189:Retrospective Studies; D012529:Saudi Arabia / Q000453:epidemiology; D013727:Terminal Care / Q000458:organization & administration* / Q000706:statistics & numerical data; D063128:Tertiary Health Care; D013997:Time Factors; D055815:Young Adult
keywords: aggressiveness; cancer deaths; do-not-resuscitate orders; end-of-life care; intensive care unit; timing of palliative care