Misalignment Between Expected Prognosis and Goals of Care After Cardiac Arrest

In a large registry, do-not-resuscitate orders were both underused and overused given patients' expected prognosis for neurological recovery.

Chances of neurological recovery after cardiac arrest vary depending on comorbidities and the circumstances of the arrest. When the perceived prognosis is poor, surrogates may opt for care limitations such as do-not-resuscitate (DNR) orders. We do not know how well these decisions correlate with the chances of recovery. Investigators therefore assessed the association between prognosis and DNR orders after in-hospital cardiac arrests between 2006 and 2012 at 406 hospitals participating in the Get With The Guidelines—Resuscitation registry. They determined prognosis using the CASPRI score, which was derived and internally validated in this same registry in 2012. A favorable outcome was defined as survival to hospital discharge without severe…

Reviewing Author

Hooman Kamel, MD

Disclosures

Speaker’s bureauGenentech

Grant / Research supportNational Institutes of Health/National Institute of Neurological Disorders and Stroke; Michael Goldberg Stroke Research Fund

Editorial boardsPLOS One; Scientific Reports

Leadership positions in professional societiesNeurocritical Care Society (Research Committee Member)

Hooman Kamel, MD

Disclosures

Speaker’s bureauGenentech

Grant / Research supportNational Institutes of Health/National Institute of Neurological Disorders and Stroke; Michael Goldberg Stroke Research Fund

Editorial boardsPLOS One; Scientific Reports

Leadership positions in professional societiesNeurocritical Care Society (Research Committee Member)

Misalignment Between Expected Prognosis and Goals of Care After Cardiac Arrest

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Reviewing Author