Background: Resuscitation orders describe individual preferences guiding the provision of potentially life-saving interventions in the event of critical deterioration, such as cardiopulmonary resuscitation (CPR). Stroke-related and social factors may influence resuscitation order completion and content.
Aims: The purpose of this study was to examine factors associated with differing stroke inpatient resuscitation order completion rates and content.
Methods: This retrospective cohort study examined resuscitation orders in consecutive individuals admitted to a tertiary stroke centre with ischaemic stroke or intracerebral haemorrhage (ICH) over a 21-month period (March 2020 to January 2022). Multivariable logistic regression was used to identify factors associated with resuscitation order completion and content.
Results: 1924 individuals were included in the study. The proportion of individuals who had resuscitation orders completed was 37.4%. Increased odds of increased resuscitation order completion were seen in patients receiving endovascular thrombectomy (Odds Ratio (OR) 1.40 [95% confidence interval (CI) 1.07-1.82]; p=0.013) and presenting with ICH (OR: 1.57 (95% CI 1.19-2.07; p=0.001). Females were more likely to have a not for CPR resuscitation order (OR:1.66 [95%CI 1.08-2.54]; p=0.021). Patients with intracerebral haemorrhage were also more likely have a not for CPR order (OR: 1.87 [95%CI 1.04-3.35]; p=0.037)
Conclusion: Disparities exist in resuscitation order completion and content based on demographic and stroke characteristics. Further research is required to identify the reasons for these differences, determine their appropriateness and to optimise resuscitation order completion.