• Ofer Kobo, Saadiq M Moledina, Mohamed O Mohamed, Aynharan Sinnarajah, Jessica Simon, Louise Y Sun, Michael Slawnych, David L Fischman, Ariel Roguin, and Mamas A Mamas.
• Department of Cardiology, Hillel Yaffe Medical Centre, Hadera, Israel; Keele Cardiovascular Research Group, Centre for Prognosis Research, Keele University, Keele, UK.
• Mayo Clin. Proc. 2023 Apr 1; 98 (4): 569578569-578.

ObjectiveTo examine the predictors, treatments, and outcomes of the use of palliative care in patients hospitalized with acute myocardial infarction (AMI) who had a do-not-resuscitate (DNR) order.Patients And MethodsUsing the National (Nationwide) Inpatient Sampling database for 2015-2018, we examined the predictors, in-hospital procedures, and outcomes of palliative care recipients among patients with AMI who had a DNR order.ResultsWe identified 339,270 admissions with AMI that had a DNR order, including patients who received palliative care (n=113,215 [33.4%]). Compared with patients who did not receive palliative care, these patients were more frequently younger (median age, 81 vs 83 years; P<.001), were less likely to be female (50.9% [57,626 of 113,215] vs 54.7% [123,652 of 226,055]; P<.001), and were more likely to present with cardiac arrest (11.6% [13,133 of 113,215] vs 6.9% [15,598 of 226,055]; P<.001). Patients were more likely to receive palliative care at a large (odds ratio [OR], 1.47; 95% CI, 1.44 to 1.50) or teaching (OR, 2.10; 95% CI, 2.04 to 2.16) hospitals compared with small or rural ones. Patients receiving palliative care were less likely to be treated invasively, with reduced rates of invasive coronary angiography (OR, 0.46; 95% CI, 0.45 to 0.47) and percutaneous coronary intervention (OR, 0.47; 95% CI, 0.45 to 0.48), and were more likely to die in the hospital (52.4% [59,325 of 113,215] vs 22.9% [51,766 of 226,055]).ConclusionIn patients who had a DNR status and were hospitalized and received a diagnosis of AMI, only one-third received palliative care.Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.

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