Table 2.
The adjusted odds ratio in code status conversation practice patterns between emergency clinicians and palliative care clinicians (adjusted for the occupational role, years of clinical experience, and frequency of code status conversations)
| Survey Questions | Crude Odds Ratio (95% CI) | p-value | Adjusted for the occupational role, clinical experience, and frequency of code status conversation | Adjusted for the occupational role, clinical experience, and frequency of code status conversation and institution | ||
|---|---|---|---|---|---|---|
| Adjusted Odds Ratio (95% CI) |
p-value | Adjusted Odds Ratio (95% CI) |
p-value | |||
| Odds of asking procedure-based questions by emergency clinicians (reference = palliative care clinicians) | ||||||
| Ask “would your father want to be on a breathing machine?” | 34.1 (14.1–82.7) | <0.001 | 47.4 (15.3–147.6) | <0.001 | 50.9 (15.9–162.4) | <0.001 |
| Ask “would your father want everything done?” | 50.5 (6.8–375.1) | <0.001 | 45.4 (5.9–346.9) | <0.001 | 45.2 (5.9–345.4) | <0.001 |
| Ask “would your father want us to restart his heart if it stops?” | 29.9 (12.5–71.6) | <0.001 | 29.8 (10.6 –84.2) | <0.001 | 31.1 (10.9–88.9) | <0.001 |
| Ask about the patient’s preference for central line placement. | 28.7 (6.7–122.4) | <0.001 | 22.6 (5.2 – 99.5) | <0.001 | 22.8 (5.2 – 100.1) | <0.001 |
| Ask about the patient’s preference for vasopressors. | 6.9 (2.8–17.2) | <0.001 | 5.8 (2.2–15.4) | <0.001 | 5.9 (2.2 – 15.5) | <0.001 |
| Explain the probability of survival from intubation and critical care. | 0.6 (0.2–1.4) | 0.221 | 0.8 (0.3–2.2) | 0.678 | 0.8 (0.3 – 2.2) | 0.702 |
| Odds of asking procedure-based questions by palliative care clinicians (reference = emergency medicine clinicians) | ||||||
| Provide a recommendation to the patient or surrogate whether or not tointubate. | 43.8 (12.9–149.2) | <0.001 | 37.5 (10.0–140.9) | <0.001 | 37.3 (9.9–139.9) | <0.001 |
| Ask “what would your father say would be most important to him if timewere to be short?” | 22.8 (7.7–67.0) | <0.001 | 16.4 (5.3–50.6) | <0.001 | 20.3 (6.2–66.4) | <0.001 |
| Explore patient’s minimum quality of life that he would consider living. | 14.4 (4.9–42.1) | <0.001 | 11.5 (3.8–35.2) | <0.001 | 11.7 (3.8–36.0) | <0.001 |
| Ask “how much more would your father say he would be willing to gothrough for possibility of more time?” | 7.5 (3.6–15.9) | <0.001 | 5.7 (2.5–13.3) | <0.001 | 6.1 (2.6–14.3) | <0.001 |
| Ask “what could your father do on his good days in the past one month?” | 6.3 (3.0–13.2) | <0.001 | 4.9 (2.2–10.9) | <0.001 | 5.0 (2.2–11.1) | <0.001 |
| Attempt to contact the patient’s primary outpatient clinician | 3.0 (1.5–6.1) | 0.002 | 2.4 (1.1–5.2) | 0.026 | 2.4 (1.1–5.2) | 0.027 |
| Ask “what is your understanding of your father's illness?” | 3.2 (0.7–14.3) | 0.124 | 2.8 (0.6–13.5) | 0.208 | 2.8 (0.6–13.9) | 0.206 |