16 June 2021

‘Do not resuscitate’ orders were common in patients admitted with suspected COVID-19

Nearly a third of patients admitted to hospital with suspected COVID-19 during the first wave of the pandemic had a ‘Do Not Attempt Cardiopulmonary Resuscitation’ (DNACPR) decision recorded before or on their day of admission to hospital.

An ambulance seen from the side
  • University of Sheffield research has found 31 per cent of patients admitted to UK hospitals with suspected COVID-19 during the first wave of the pandemic had a ‘Do Not Attempt Cardiopulmonary Resuscitation’ (DNACPR) decision recorded before or on their day of admission
  • Study has revealed this DNACPR rate is higher than the rates reported in previous studies of conditions similar to COVID-19 before the pandemic
  • Results show that 59 per cent of patients with a DNACPR decision survived their acute illness and 12 per cent received intensive treatment aimed at saving their life
  • Patients with a DNACPR decision received some intensive treatments as frequently as those with no DNACPR decision, providing reassurance that doctors are not denying DNACPR patients potentially life-saving treatment, according to study

Nearly a third of patients admitted to hospital with suspected COVID-19 during the first wave of the pandemic had a ‘Do Not Attempt Cardiopulmonary Resuscitation’ (DNACPR) decision recorded before or on their day of admission to hospital, new research has found. 

The study, led by Professor Steve Goodacre from the University of Sheffield’s School of Health and Related Research (ScHARR) and funded by the National Institute for Health Research, has revealed that this is higher than the rates reported in previous studies of conditions similar to COVID-19 before the pandemic.

Published in the journal Resuscitation, the study found that 59 per cent of patients with a DNACPR decision survived their acute illness and 12 per cent received intensive treatment aimed at saving their life. 

People with a DNACPR decision received some intensive treatments as frequently as those with no DNACPR decision. This provides reassurance that doctors were not denying patients with DNACPR decisions potentially life-saving treatment.

The research also found that people of Asian ethnicity were less likely to have a DNACPR decision on or before their day of admission to hospital. The reasons for this are not clear and the researchers highlighted the need for further studies into the discussions that take place when people from ethnic minorities are admitted to hospital with COVID-19 or other serious illnesses.

The findings come from the University of Sheffield-led PRIEST study, which was originally set up to evaluate ways of assessing the severity of COVID-19 in people attending emergency departments. The research team analysed data relating to DNACPR decisions from 12748 adults in the study after the Care Quality Commission undertook a review of the use of DNACPR decisions in the pandemic.

Professor Steve Goodacre, Professor of Emergency Medicine at the University of Sheffield’s School of Health and Related Research (ScHARR), said: “DNACPR decisions are an important element of providing appropriate care for seriously ill patients but they should not be used as a reason to withhold potentially life-saving treatment. 

“Our findings show that many people who had a DNACPR decision during the first wave of the pandemic received an intensive life-saving treatment.”

The research paper, Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decisions in people admitted with suspected COVID-19: Secondary analysis of the PRIEST observational cohort study, is published in the journal Resuscitation. Read the paper.

Contact

For further information please contact: