title: Patients' characteristics associated with the decision of "do not attempt cardiopulmonary resuscitation" order in a Swiss hospital.
abstract: BACKGROUND
  According to Swiss legislation, do not attempt cardiopulmonary resuscitation (DNACPR) order can be made at any time by patients only, unless the resuscitation is considered as futile, based on the doctors' evaluation. Little is known about how this decision is made, and which are the factors influencing this decision.
  
  
  METHODS
  Observational, cross-sectional study was conducted between March and May 2013 on 194 patients hospitalized in the general internal medicine ward of a Swiss hospital. The associations between patients' DNACPR orders and gender, age, marital status, nationality, religion, number and type of comorbidities were assessed.
  
  
  RESULTS
  102 patients (53%) had a DNACPR order: 27% issued by the patient him/herself, 12% by his/her relatives and 61% by the medical team. Patients with a DNACPR order were significantly older: 80.7 ± 10.8 vs. 67.5 ± 15.1 years in the "with" and "without" DNACPR order group, respectively, p < 0.001. Oncologic disease was associated with a DNACPR order issued by the medical team (37.5% vs. 16.9% in the "with" and "without" DNACPR order group, respectively, p < 0.05). Being protestant was associated with a DNACPR order issued by the patient (57.9% vs. 25.9% in the "with" and "without" DNACPR order group, respectively p < 0.01).
  
  
  CONCLUSIONS
  Over half of the patients admitted to a general internal medicine ward had a DNACPR order issued within the first 72 h of hospitalization. Older age and oncologic disease were associated with a DNACPR decision by the medical team, while protestant religion was associated with a DNACPR decision by the patient.
authors.affiliation: Department of Internal Medicine, Internal Medicine, Lausanne University Hospital, rue du Bugnon 46, CH-1011 Lausanne, Switzerland. Electronic address: Fabienne.Chevaux@chuv.ch.
authors.forename: Fabienne
authors.initials: F
authors.lastname: Chevaux
authors.affiliation: Department of Internal Medicine, Internal Medicine, Lausanne University Hospital, rue du Bugnon 46, CH-1011 Lausanne, Switzerland. Electronic address: Mariangela.Gagliano@ehc.vd.ch.
authors.forename: Mariangela
authors.initials: M
authors.lastname: Gagliano
authors.affiliation: Department of Internal Medicine, Internal Medicine, Lausanne University Hospital, rue du Bugnon 46, CH-1011 Lausanne, Switzerland. Electronic address: Gerard.Waeber@chuv.ch.
authors.forename: Gérard
authors.initials: G
authors.lastname: Waeber
authors.affiliation: Department of Internal Medicine, Internal Medicine, Lausanne University Hospital, rue du Bugnon 46, CH-1011 Lausanne, Switzerland. Electronic address: Pedro-Manuel.Marques-Vidal@chuv.ch.
authors.forename: Pedro
authors.initials: P
authors.lastname: Marques-Vidal
authors.affiliation: Department of Internal Medicine, Internal Medicine, Lausanne University Hospital, rue du Bugnon 46, CH-1011 Lausanne, Switzerland; Service of Internal Medicine, Groupement Hospitalier de l'Ouest Lémanique, chemin Monastier 10, 1260 Nyon, Switzerland. Electronic address: Marcos.Schwab@ghol.ch.
authors.forename: Marcos
authors.initials: M
authors.lastname: Schwab
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016887:Cardiopulmonary Resuscitation; D003430:Cross-Sectional Studies; D003657:Decision Making; D005260:Female; D006304:Health Status; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D016414:Resuscitation Orders; D012959:Socioeconomic Factors; D013557:Switzerland; D013997:Time Factors
keywords: Decision making; Ethics; Resuscitation orders