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The hypothesis of the study is that a resuscitation order other than full code is associated with increased mortality among critically ill patients. By incorporating conventional variables associated with death such as age, sex, and Simplified Acute Physiological Score, as well as including the new Clinical Frailty Scale in a statistical model, the aim is to investigate whether there is still an increased risk of death that remains unexplained.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Full code | Patients without any restrictions on the types of treatments available, such as cardiopulmonary resuscitation, intubation, various life support measures, surgery, etc., if indicated. |
| |
| Simple Do-Not-Attempt-Resuscitation | The only treatment limitation in patient care is cardiopulmonary resuscitation in case of a cardiac arrest. All other indicated devices or treatments may still be utilized. |
| |
| Do not attempt resuscitation with limited scope | The treatment limitation in patient care includes not performing cardiopulmonary resuscitation and also involve additional limitations, typically including various life support measures. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Resuscitation orders | Other | Resuscitation orders, commonly referred to as Code Status, communicate to the healthcare team the specific medical interventions that patients will receive while hospitalised. These orders are issued by a doctor and require confirmation by at least one other licensed medical professional |
| Measure | Description | Time Frame |
|---|---|---|
| Mortality | Hazard ratio of death | 365 days |
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Inclusion Criteria:
Exclusion Criteria:
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Critically ill patients admitted to the intensive care unit during 2023 and 2024
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| Name | Affiliation | Role |
|---|---|---|
| Sandra Jonmarker | Stockholm South General Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Karolinska Institute | Stockholm | 11883 | Sweden |
The privacy of the data is protected under Swedish law, and the original patient data will be stored in a de-identified form for 10 years in accordance with Karolinska Institute regulations. Use of the de-identified data for research purposes beyond those specified in this registration may be considered, but requires additional approval from the Swedish Ethics Committee.
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| ID | Term |
|---|---|
| D016638 | Critical Illness |
| ID | Term |
|---|---|
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| ID | Term |
|---|---|
| D016414 | Resuscitation Orders |
| ID | Term |
|---|---|
| D012151 | Resuscitation |
| D004638 | Emergency Treatment |
| D013812 | Therapeutics |
| D013727 | Terminal Care |
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|
| D005791 |
| Patient Care |
| D006296 | Health Services |
| D005159 | Health Care Facilities Workforce and Services |
| D007603 | Jurisprudence |
| D012926 | Social Control, Formal |
| D004472 | Health Care Economics and Organizations |