PMID- 36913360
OWN - NLM
STAT- MEDLINE
DCOM- 20230315
LR  - 20230420
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 18
IP  - 3
DP  - 2023
TI  - Factors affecting do-not-resuscitate decisions among patients with amyotrophic 
      lateral sclerosis in Taiwan.
PG  - e0282805
LID - 10.1371/journal.pone.0282805 [doi]
LID - e0282805
AB  - Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease. Usually, 
      patients survive for approximately 2-4 years after the onset of the disease, and 
      they often die of respiratory failure. This study examined the factors associated 
      with signing a "do not resuscitate" (DNR) form in patients with ALS. This 
      cross-sectional study included patients diagnosed with ALS between January 2015 
      and December 2019 in a Taipei City hospital. We recorded patients' age at disease 
      onset; sex; presence of diabetes mellitus, hypertension, cancer, or depression; 
      use of invasive positive pressure ventilator (IPPV) or non-IPPV (NIPPV); use of 
      nasogastric tube (NG) or percutaneous endoscopic gastrostomy (PEG) tube; 
      follow-up years; and number of hospitalizations. Data from 162 patients were 
      recorded (99 men). Fifty-six (34.6%) signed a DNR. Multivariate logistic 
      regression analyses revealed that the factors associated with DNR included NIPPV 
      (OR = 6.95, 95% CI = 2.21-21.84), PEG tube feeding (OR = 2.86, 95% CI = 
      1.13-7.24), NG tube feeding (OR = 5.75, 95% CI = 1.77-18.65), follow-up years (OR 
      = 1.13, 95% CI = 1.02-1.26), and number of hospital admissions (OR = 1.26, 95% CI 
      = 1.02-1.57). The findings suggest that end-of-life decision making among 
      patients with ALS may often be delayed. DNR decisions should be discussed with 
      patients and their families during the early stages of disease progression. 
      Physicians are advised to discuss DNR with patients when they can speak and to 
      offer palliative care options.
CI  - Copyright: (c) 2023 Chuang et al. This is an open access article distributed under 
      the terms of the Creative Commons Attribution License, which permits unrestricted 
      use, distribution, and reproduction in any medium, provided the original author 
      and source are credited.
FAU - Chuang, Mei-Hsing
AU  - Chuang MH
AD  - Division of Family Medicine, Taipei City Hospital Zhong Xiao Branch, Taipei, 
      Taiwan.
AD  - Department of Family Medicine, School of Medicine, National Yang Ming Chiao Tung 
      University, Taipei, Taiwan.
FAU - Hsu, Jiunn-Rong
AU  - Hsu JR
AD  - Division of Chest Medicine, Department of Internal Medicine, Taipei City Hospital 
      Zhong Xiao Branch, Taipei, Taiwan.
FAU - Hung, Chia-Wei
AU  - Hung CW
AD  - Division of Neurology, Department of Internal Medicine, Taipei City Hospital 
      Zhong Xiao Branch, Taipei, Taiwan.
FAU - Hwang, Yu Long
AU  - Hwang YL
AD  - Division of Neurology, Department of Internal Medicine, Taipei City Hospital 
      Zhong Xiao Branch, Taipei, Taiwan.
FAU - Lee, Chih-Ching
AU  - Lee CC
AD  - Division of Palliative Medicine, Department of Internal Medicine, Taipei City 
      Hospital Zhong Xiao Branch, Taipei, Taiwan.
FAU - Shen, Hsiu-Yi
AU  - Shen HY
AD  - Department of Nursing, Taipei City Hospital Zhong Xiao Branch, Taipei, Taiwan.
FAU - Chang, Fu-Kang
AU  - Chang FK
AUID- ORCID: 0000-0002-3602-6881
AD  - Division of Chest Medicine, Department of Internal Medicine, Taipei City Hospital 
      Zhong Xiao Branch, Taipei, Taiwan.
FAU - Kuo, Li-Lin
AU  - Kuo LL
AUID- ORCID: 0000-0001-5412-578X
AD  - Department of Ophthalmology, Taipei City Hospital, Taipei, Taiwan.
FAU - Chen, Saint Shiou-Sheng
AU  - Chen SS
AD  - Division of Urology, Taipei City Hospital Zhong Xiao Branch, Taipei, Taiwan.
AD  - Department of Urology, National Yang Ming Chiao Tung University, School of 
      Medicine, Taipei, Taiwan.
AD  - Commission for General Education, College of Applied Science, National Taiwan 
      University of Science and Technology, Taipei, Taiwan.
AD  - General Education Center, University of Taipei, Taipei, Taiwan.
FAU - Huang, Sheng-Jean
AU  - Huang SJ
AD  - Department of Surgery, College of Medicine, National Taiwan University, Taipei, 
      Taiwan.
LA  - eng
PT  - Journal Article
DEP - 20230313
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
SB  - IM
MH  - Male
MH  - Humans
MH  - Resuscitation Orders
MH  - *Amyotrophic Lateral Sclerosis/therapy/complications
MH  - Taiwan/epidemiology
MH  - Cross-Sectional Studies
MH  - *Neurodegenerative Diseases/complications
MH  - Death
MH  - Retrospective Studies
PMC - PMC10010504
COIS- The authors have declared that no competing interests exist.
EDAT- 2023/03/14 06:00
MHDA- 2023/03/16 06:00
PMCR- 2023/03/13
CRDT- 2023/03/13 13:34
PHST- 2022/10/11 00:00 [received]
PHST- 2023/02/22 00:00 [accepted]
PHST- 2023/03/13 13:34 [entrez]
PHST- 2023/03/14 06:00 [pubmed]
PHST- 2023/03/16 06:00 [medline]
PHST- 2023/03/13 00:00 [pmc-release]
AID - PONE-D-22-28158 [pii]
AID - 10.1371/journal.pone.0282805 [doi]
PST - epublish
SO  - PLoS One. 2023 Mar 13;18(3):e0282805. doi: 10.1371/journal.pone.0282805. 
      eCollection 2023.