Racial variation in the use of do-not-resuscitate orders
Racial variation in the use of do-not-resuscitate orders
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DOI：
10.1046/j.1525-1497.1999.00275.x
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发表时间：
1999-01-01
影响因子：
5.7
通讯作者：
Rosenthal, GE
中科院分区：
文献类型：
--
作者：
Shepardson, LB;Gordon, HS;Rosenthal, GE
目的：使用大型、多地点、社区样本来比较非裔美国人和白人患者对不复苏 (DNR) 命令的使用情况。 测量：我们的样本包括 1993 年至 1995 年间在一个大都市地区的 30 家医院因 6 种非手术病症连续入院的 90,821 例患者。人口统计和临床数据从病历中提取。使用具有良好区分度的多变量风险调整模型来测量入院疾病严重程度（接受者操作特征曲线面积，0.82-0.88），使用多重逻辑回归分析来确定种族和 DNR 指令使用之间的独立关联，调整年龄、入院严重程度和 ol:her 协变量。 主要结果：在所有患者中，非裔美国人的 DNR 指令比率低于白人（9% vs 18%：p
OBJECTIVE: To compare the use of do-not-resuscitate (DNR) orders in African-American and white patients using a large, multisite, community-based sample.MEASUREMENTS: Our sample included 90,821 consecutive admissions to 30 hospitals in a large metropolitan region with six nonsurgical conditions from 1993 through 1995. Demographic and clinical data were abstracted from medical records. Admission severity of illness was measured using multivariate risk-adjustment models with excellent discrimination (receiver-operating characteristic curve areas, 0.82-0.88), Multiple logistic regression analysis was used to determine the independent association between race and use of DNR orders, adjusting for age, admission severity, and ol:her covariates.MAIN RESULTS: In all patients, the rate of DNR orders was lower in African Americans than whites (9% vs 18%: p