A population-based study on the prevalence and determinants of cardiopulmonary resuscitation in the last month of life for Taiwanese cancer decedents, 2001-2006

Background: The success rate of cardiopulmonary resuscitation (CPR) for cancer patients following in-hospital cardiac arrest has remained poor over the last 3 decades, but little is known about determinants of undergoing CPR for these patients at the end of life. Objective: To determine the prevalence of CPR for Taiwanese cancer patients in the last month of life and the association between their undergoing CPR and patient demographics, disease characteristics, physician specialty, hospital characteristics, and availability of healthcare resources at the hospital and regional levels. Methods: This retrospective cohort study examined administrative data for a cohort of 204,850 cancer decedents in 2001-2006. Results: Rates of CPR decreased substantially over the study period, from 13.18% to 8.63%, and the adjusted odds ratio of undergoing CPR decreased significantly by a factor of 0.93 for each successive year. Taiwanese cancer patients were predisposed to undergo CPR in their last month of life if they were male, young, and unmarried (except for widowhood); had high comorbidity; had certain cancers (hematological malignancies, head and neck, esophageal, and prostate cancers); had a localized or newly diagnosed (within 1-2 months of death) cancer; had a non-oncologist as their primary physician; and received care at a non-teaching hospital. Conclusion: One-tenth of Taiwanese cancer patients underwent CPR in the last month of life, and the rates of CPR decreased substantially from 2001 to 2006. The propensity for CPR was influenced by patient demographics, disease characteristics, physician specialty, and teaching status of the patient's primary hospital.