A decision to refrain from cardiopulmonary resuscitation (CPR) in the case of cardiac arrest is recommended in terminally ill patients to avoid unnecessary suffering at time of death. The aim of this study was to describe the frequency of decisions and documentation of “do not attempt cardiopulmonary resuscitation” (DNACPR) in two Medical Home Care Units in Stockholm. Unit A had written guidelines about how to document CPR-decisions in the medical records, including a requirement for a decision to be taken (CPR: yes/no) while Unit B had no such requirement. The medical records for all patients in palliative phase of their disease at the two Units were reviewed. Data was collected on documentation of decisions about CPR (yes/no), DNACPR-decisions and documentation regarding whether the patient or next-of-kin had been informed about the DNACPR-decision. In the two Units, 316 and 219 patients in palliative phase were identified. In Unit A 100% of the patients had a CPR-decision (yes/no) compared to 79% in Unit B (p < 0.001). There was no statistically significant difference in DNACPR-decisions between the two Units, 43 and 37%. Documentation about informing the patient regarding the decision was significantly higher in Unit A, 53% compared to 14% at Unit B (p < 0.001). Documentation about informing the next-of-kin was also significantly higher at Unit A; 42% compared to 6% at Unit B (p < 0.001). Less than 50% of patients in palliative phase had a decision of DNACPR in two Medical Home Care Units in Stockholm. The presence of written guidelines and a requirement for a CPR-decision did not increase the frequency of DNACPR-decisions but was associated with a higher frequency of documentation of decisions and of information given to both the patients and the next-of-kin.

中文翻译：

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瑞典两个医疗家庭护理部门中决定不进行复苏的决定和文件的比较研究

对于绝症患者，建议在心脏骤停时避免心肺复苏（CPR），以避免死亡时不必要的痛苦。这项研究的目的是描述斯德哥尔摩两个医疗家庭护理部门中“请勿尝试心肺复苏”（DNACPR）的决定和文献记录的频率。A单元已制定有关如何在病历中记录CPR决定的书面指南，包括要做出决定的要求（CPR：是/否），而B单位则没有这样的要求。回顾了两个部门所有处于疾病姑息阶段的患者的病历。收集了有关CPR决策文件的数据（是/否），DNACPR决定和有关患者或亲属是否已被告知有关DNACPR决定的决定和文档。在这两个部门中，确定了316例和219例处于姑息期的患者。在A单元中，有100％的患者有CPR决定（是/否），而B单元中有79％（p <0.001）。两个单元之间的DNACPR决定没有统计学上的显着差异，分别为43％和37％。A单元中有关告知患者有关决定的文档的比例明显更高，为53％，而B单元为14％（p <0.001）。通知亲戚的文件在A单元也要高得多；42％，而B单元为6％（p <0.001）。在斯德哥尔摩的两个医疗家庭护理部门中，只有50％处于姑息治疗阶段的患者做出了DNACPR的决定。