Abstract:
BACKGROUND:Little is known about the outcomes of in-hospital cardiopulmonary resuscitation (CPR) in Asian populations including elderly patients in Japan. OBJECTIVE:To determine the survival outcome of in-hospital CPR among elderly patients in Japan, and to identify predictors associated with survival. DESIGN:Retrospective cohort study in 81 Japanese hospitals from April 1, 2010 to March 31, 2016. PATIENTS:We included elderly patients (age ≥ 65 years) who received CPR after 2 days of hospitalization. MAIN MEASURES:The primary outcome was survival at hospital discharge and the secondary outcomes were the discharge disposition and consciousness level of patients who survived to hospital discharge. To determine predictors associated with survival after in-hospital CPR, we fit multivariable models for patient-level and institutional-level factors. KEY RESULTS:Among the 5365 patients who received CPR, 595 (11%) survived to discharge. Of those who survived to discharge, 46% of patients were discharged home, and 10% of patients were comatose at discharge. Older age and higher burden of comorbidities were associated with reduced survival. The adjusted OR was 0.35 (95% CI, 0.22-0.55) for age ≥ 90 years compared to age 65-69 years, and 0.68 (95% CI, 0.48-0.97) for Charlson Comorbidity Index score of ≥ 4 compared with score of 0. Other predictors of reduced survival included receiving CPR on weekends compared to weekdays (AOR, 0.63; 95% CI, 0.51-0.77) and in small hospitals compared to large hospitals (AOR, 0.58; 95% CI, 0.40-0.83). CONCLUSIONS:Among elderly patients in Japan, the survival rate of in-hospital CPR was approximately one in ten, and less than half of these patients were discharged home. In addition to older age and higher illness burden, receiving CPR on weekends and/or in small hospitals were significant predictors of reduced survival. These findings should be considered in advanced care planning discussions with elderly patients to avoid subjecting patients to CPR that are likely futile.
journal_name
J Gen Intern Medjournal_title
Journal of general internal medicineauthors
Hayashi T,Matsushima M,Bito S,Kanazawa N,Inoue N,Luthe SK,Wee CCdoi
10.1007/s11606-018-4747-5subject
Has Abstractpub_date
2019-02-01 00:00:00pages
206-210issue
2eissn
0884-8734issn
1525-1497pii
10.1007/s11606-018-4747-5journal_volume
34pub_type
杂志文章abstract:BACKGROUND:Stigma is associated with depression treatment, however, whether stigma differs between depression treatment modalities is not known, nor have racial differences in depression treatment stigma been fully explored. OBJECTIVE:To measure stigma for four depression treatments and estimate its association with t...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-007-0276-3
更新日期:2007-09-01 00:00:00
abstract::Multiple factors are driving residency programs to explicitly address practice-based learning and improvement (PBLI), yet few information systems exist to facilitate such training. We developed, implemented, and evaluated a Web-based tool that provides Internal Medicine residents at the University of Virginia Health S...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-007-0467-y
更新日期:2008-04-01 00:00:00
abstract:BACKGROUND:Physician opinion can influence the prospects for health care reform, yet there are few recent data on physician views on reform proposals or access to medical care in the United States. OBJECTIVE:To assess physician views on financing options for expanding health care coverage and on access to health care....
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-009-0916-x
更新日期:2009-04-01 00:00:00
abstract:OBJECTIVES:The telephone can facilitate medical care but also result in adverse outcomes leading to telephone-related malpractice suits. Analyzing claims might identify errors amenable to prevention. The objective of the study was to describe medical errors involving the telephone in patient-clinician encounters that s...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-007-0491-y
更新日期:2008-05-01 00:00:00
abstract:OBJECTIVE:To explore the effect of race on primary care quality and satisfaction among women in the Department of Veterans Affairs (VA). METHODS:We used a mail survey to measure primary care quality and satisfaction. We focused on 4 primary care domains: patient preference for provider, interpersonal communication, ac...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1111/j.1525-1497.2006.00517.x
更新日期:2006-10-01 00:00:00
abstract:BACKGROUND:Rates of substance use in rural areas are close to those of urban areas. While recent efforts have emphasized integrated care as a promising model for addressing workforce shortages in providing behavioral health services to those living in medically underserved regions, little is known on how substance use ...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s11606-015-3488-y
更新日期:2016-02-01 00:00:00
abstract:OBJECTIVE:Examine patterns of alcohol use disorder (AUD) medication use and identify factors associated with prescription fill among commercially insured individuals with an index AUD visit. DESIGN:Using 2008-2018 claims data from a large national insurer, estimate days to first AUD medication using cause-specific haz...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-020-06073-w
更新日期:2020-11-01 00:00:00
abstract::Patients can obtain screening mammograms without a physician's referral, leading to potential problems in clinical care. Because of the complexity of self-referral and the limitations of prior studies, we examined this phenomenon in a representative sample of mammography facilities. A questionnaire was given to all wo...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1046/j.1525-1497.1998.00209.x
更新日期:1998-10-01 00:00:00
abstract:PURPOSE:Middle-aged men are at high risk of suicide. While about half of those who kill themselves visit a primary care clinician (PCC) shortly before death, in current practice, few spontaneously disclose their thoughts of suicide during the visits, and PCCs seldom inquire about such thoughts. In a randomized controll...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-020-05769-3
更新日期:2020-07-01 00:00:00
abstract:BACKGROUND:Inappropriate antibiotic use contributes to the emergence and spread of drug resistant infections. Though injection drug users are at increased risk for drug resistant infections, few studies have examined antibiotic use in this population. OBJECTIVE:To understand patterns and determinants of antibiotic use...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-008-0859-7
更新日期:2009-02-01 00:00:00
abstract:OBJECTIVE:To determine the incremental cost-effectiveness of a quality improvement depression intervention (enhanced care) in primary care settings relative to usual care. DESIGN:Following stratification, we randomized 12 primary care practices to enhanced or usual care conditions and followed patients for 12 months. ...
journal_title:Journal of general internal medicine
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1046/j.1525-1497.2003.20611.x
更新日期:2003-06-01 00:00:00
abstract:OBJECTIVES:Among patients unlikely to attend a scheduled colonoscopy, we examined the impact of peer coach versus educational brochure support and compared these with concurrent patients who did not receive support. METHODS:From health system data, we identified 275 consecutive patients aged >50 who kept <75% of visit...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,随机对照试验
doi:10.1007/s11606-007-0445-4
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND:Post-hospital discharge follow-up appointments are intended to evaluate patients' recovery following a hospitalization, but it is unclear how appointment statuses are associated with readmissions. OBJECTIVE:To examine the association between post-discharge ambulatory follow-up status, (1) having a scheduled...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-020-06569-5
更新日期:2021-01-19 00:00:00
abstract:BACKGROUND:Patient navigator (PN) programs can improve breast cancer screening in low income, ethnic/racial minorities. Refugee women have low breast cancer screening rates, but it has not been shown that PN is similarly effective. OBJECTIVE:Evaluate whether a PN program for refugee women decreases disparities in brea...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-013-2491-4
更新日期:2013-11-01 00:00:00
abstract:BACKGROUND:Increasing the use of electronic medical records (EMR) has been suggested as an important strategy for improving healthcare safety. OBJECTIVE:To sequentially measure, evaluate, and respond to safety culture and practice safety concerns following EMR implementation. DESIGN:Safety culture was assessed using ...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-012-2153-y
更新日期:2013-02-01 00:00:00
abstract:BACKGROUND:Heart disease is the leading cause of death for women in the United States, accounting for 24.5 % of all deaths among women. Earlier research has demonstrated racial/ethnic differences in prevalence of cardiovascular (CVD) risk factors. OBJECTIVE:To empirically examine the prevalence of CVD risk factors amo...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,随机对照试验
doi:10.1007/s11606-012-2309-9
更新日期:2013-07-01 00:00:00
abstract::The American Board of Internal Medicine suggests use of a standard form to rate residents on nine dimensions (such as clinical judgment and overall clinical competence) on a scale of 1 to 9. The authors examined the psychometric evidence for reliability and validity of 1,039 ratings of 85 residents by 135 attendings i...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02600537
更新日期:1990-05-01 00:00:00
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journal_title:Journal of general internal medicine
pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2013-12-01 00:00:00
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journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1046/j.1525-1497.1997.00083.x
更新日期:1997-08-01 00:00:00
abstract:BACKGROUND:The high prevalence of comorbid physical and mental illnesses among veterans is well known. Therefore, ensuring effective communication between primary care (PC) and mental health (MH) clinicians in the Veterans Affairs (VA) health care system is essential. The VA's Patient Aligned Care Teams (PACT) initiati...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
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更新日期:2014-07-01 00:00:00
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journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-010-1363-4
更新日期:2010-09-01 00:00:00
abstract:BACKGROUND:For more than a decade, the presence of diabetes has been considered a coronary heart disease (CHD) "risk equivalent". OBJECTIVE:The objective of this study was to revisit the concept of risk equivalence by comparing the risk of subsequent CHD events among individuals with or without history of diabetes or ...
journal_title:Journal of general internal medicine
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doi:10.1007/s11606-015-3556-3
更新日期:2016-04-01 00:00:00
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journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-016-3745-8
更新日期:2016-11-01 00:00:00
abstract::The Accreditation Council of Graduate Medical Education (ACGME) and the Residency Review Committee require a competency-based, accessible evaluation system. The paper system at our institution did not meet these demands and suffered from low compliance. A diverse committee of internal medicine faculty, program directo...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1111/j.1525-1497.2004.30065.x
更新日期:2004-05-01 00:00:00
abstract:BACKGROUND:Many national guidelines recommend the use of patient provider agreements (PPAs) when prescribing opioids for chronic pain. There are no standards for PPA content, readability, or administration processes. OBJECTIVE:Conduct a national survey of providers who use PPAs to describe the process of administering...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-020-06364-2
更新日期:2021-01-08 00:00:00
abstract:OBJECTIVES:To examine how practice constraints contribute to barriers in the health care of persons with dementia and their families, particularly with respect to behavioral aspects of care. DESIGN:Cross-sectional qualitative interview study of primary care physicians. SETTING:Physicians' offices. PARTICIPANTS:Forty...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-007-0317-y
更新日期:2007-11-01 00:00:00
abstract::One challenge of contemporary medical education is that shorter lengths of stay and time-limited clerkships often interrupt a student's relationship with a patient before a diagnosis is made or treatment is completed, limiting the learning experience. Medical students sometimes use electronic health records (EHRs) to ...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-017-4278-5
更新日期:2018-04-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Affect and how it is regulated plays a role in pain perception, maintenance of pain, and its resolution. This randomized, controlled trial evaluated an innovative affective self-awareness (ASA) intervention, which was designed to reduce pain and improve functioning in individuals with fibromyal...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,随机对照试验
doi:10.1007/s11606-010-1418-6
更新日期:2010-10-01 00:00:00
abstract:BACKGROUND:Individuals involved with the criminal justice system have increased health needs and poor access to primary care. OBJECTIVE:To examine hospital and emergency department (ED) utilization and related costs by individuals with recent criminal justice involvement. DESIGN:Cross-sectional survey. PARTICIPANTS:...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-014-2877-y
更新日期:2014-09-01 00:00:00
abstract::In rare cases, pancytopenia results from hormonal deficiencies that arise in the setting of panhypopituitarism. Here we describe the unusual case of a 60-year-old man who presented with progressive fatigue and polyuria, and whose laboratory workup revealed a deficiency of the five hormones associated with the action o...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,评审
doi:10.1007/s11606-014-3161-x
更新日期:2015-05-01 00:00:00