Patients with advanced cancer who suffer cardiac arrest in the hospital have a survival rate of less than
10 percent—half the rate of other patients without cancer, according to a nationwide study led by the University of Rochester Medical Center.
10 percent—half the rate of other patients without cancer, according to a nationwide study led by the University of Rochester Medical Center.
The data helps to clear up some myths in medicine about cardiac arrest survival and can be used as a guidepost when hospitalized cancer patients and their
families consider do-not-resuscitate (DNR) orders, said
Jeffrey T. Buckel, M.D., a third-year postdoctoral fellow
in cardiology at URMC, who led the research.
"We're hopeful that our study in some way will help
doctors and cancer patients make more informed
decisions about the end of life," Buckel said. "It's very
important to have early, frank, discussions around the
goals of care."
The study was published by the Journal of Oncology
Practice in a special end-of-life care edition.
Researchers from Rochester and collaborating institutions used a nationwide resuscitation registry to evaluate survival after cardiac arrest of more than
47,000 people at 369 hospitals. Patients who were in for surgery (before, during, and after), emergency room
treatment, rehabilitation, or treatment from cardiac catheterization labs or interventional radiology were
excluded from the study, as were patients with implantable defibrillators. Of the 47,157 patients who
experienced cardiac arrest, 6,585 or 14 percent had
advanced cancer at the time of the arrest.
Researchers also looked at how resuscitation efforts
occurred. Another myth in medicine is that patients
with advanced cancer receive less aggressive
resuscitation care, but researchers found no evidence of
that happening, Buckel said.
In fact, the average time that doctors worked to
resuscitate all patients (cancer and non-cancer) ranged
from about 22 to 24 minutes, the study showed.
However, after cancer patients were successfully
resuscitated, they more often signed DNR orders during
the next 48 hours.
When outcomes of cancer and non-cancer patients were
compared, results showed that 57.5 percent of the
cancer patients were resuscitated successfully but only
9.6 percent survived to be discharged from the
hospital; whereas 63 percent of the non-cancer patients
were successfully resuscitated and 19.2 percent
survived to the time of discharge.
Researchers reported several limitations to the study,
including a lack of detailed data on the types of
advanced cancer and cancer treatments being given
used at the time of cardiac arrest.
families consider do-not-resuscitate (DNR) orders, said
Jeffrey T. Buckel, M.D., a third-year postdoctoral fellow
in cardiology at URMC, who led the research.
"We're hopeful that our study in some way will help
doctors and cancer patients make more informed
decisions about the end of life," Buckel said. "It's very
important to have early, frank, discussions around the
goals of care."
The study was published by the Journal of Oncology
Practice in a special end-of-life care edition.
Researchers from Rochester and collaborating institutions used a nationwide resuscitation registry to evaluate survival after cardiac arrest of more than
47,000 people at 369 hospitals. Patients who were in for surgery (before, during, and after), emergency room
treatment, rehabilitation, or treatment from cardiac catheterization labs or interventional radiology were
excluded from the study, as were patients with implantable defibrillators. Of the 47,157 patients who
experienced cardiac arrest, 6,585 or 14 percent had
advanced cancer at the time of the arrest.
Researchers also looked at how resuscitation efforts
occurred. Another myth in medicine is that patients
with advanced cancer receive less aggressive
resuscitation care, but researchers found no evidence of
that happening, Buckel said.
In fact, the average time that doctors worked to
resuscitate all patients (cancer and non-cancer) ranged
from about 22 to 24 minutes, the study showed.
However, after cancer patients were successfully
resuscitated, they more often signed DNR orders during
the next 48 hours.
When outcomes of cancer and non-cancer patients were
compared, results showed that 57.5 percent of the
cancer patients were resuscitated successfully but only
9.6 percent survived to be discharged from the
hospital; whereas 63 percent of the non-cancer patients
were successfully resuscitated and 19.2 percent
survived to the time of discharge.
Researchers reported several limitations to the study,
including a lack of detailed data on the types of
advanced cancer and cancer treatments being given
used at the time of cardiac arrest.
Source : madicalxpress.com
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