Saed Al Nobani still as student in his PhD at the age of 39 years from University of Minnesota in USA, he has Master degree of Healthcare Management from Swiss Business School, and his Bachelor degree in Nursing from Jordan university2006. he is Director of Nursing , Head of Quality and Education in Elyzee Hospital, before that he was senior clinical Education Specialist, life support instructor from AHA in Cleveland Clinic Abu Dhabi before that he was the Manager of Education & life support in Enaya Hospital/ Enaya medical group in KSA-Dammam, he is certified as Healthcare consultant from American institution of healthcare Management as Patient safety officer from American institution of healthcare Management, also as CPHQ Certified from NAHQ, He has published more than 3 papers in Jordan, KSA, UAE about quality, patient safety & Oncology & waste management
Healthcare Management, Nursing
Indicators of Clinical Chemotherapy Treatment for Patients with Cancer who Experienced Cardiopulmonary Resuscitation in UAE
Introduction: Patients with cancer who require cardiopulmonary resuscitation (CPR) historically has had low survival to hospital discharge; however, overall CPR outcomes and cancer survival have improved. Identifying patients with cancer who are unlikely to survive CPR could guide and improve end-of-life discussions prior to cardiac arrest.
Methodology: Demographics, clinical variables, and outcomes including immediate and hospital survival for patients with cancer aged 18 years and above who required in-hospital CPR from 2019 to 2021 were collected. Indicators capturing the overall declining clinical and oncologic Chemotherapy Treatment (ie, no further therapeutic options for cancer, recommendation for hospice, or recommendation for do not resuscitate) prior to CPR were determined a priori and manually identified.
Results: Of 540 patients with cancer who underwent CPR, the median age was 60 years and 45.6% were female; solid cancers accounted for 60.6% of diagnoses. A recursive partitioning model selected having any indicator of declining Chemotherapy as the most predictive factor in hospital outcome. Of our study group, 186 (29%) patients were found to have at least one indicator identified prior to CPR and only 5 survived to discharge. Patients with an indicator were more likely to die in the hospital and none were alive at 6 months after discharge. These patients were younger (median age, 59 vs 64 years; P#.001), had a higher incidence of metastatic disease (83.0% vs 62.9%; P,.001), and were more likely to undergo CPR in the ICU (55.8% vs 36.5%; P,.001) compared with those without an indicator. Of patients without an indicator, 135 (25%) were discharged alive and half received some form of Chemotherapy after CPR
Conclusion: Providers can use easily identifiable indicators to ascertain which patients with cancer are at risk for death despite CPR and are unlikely to survive to discharge. These findings can guide discussions regarding utility of resuscitation and the lack of further cancer interventions even if CPR is successful.