Do-Not-Resuscitate status as an independent risk factor for patients undergoing surgery for hip fracture

World Journal of Orthopedics
Ethan Y BrovmanRichard D Urman

Abstract

To determine morbidity and mortality in hip fracture patients and also to assess for any independent associations between Do-Not-Resuscitate (DNR) status and increased post-operative morbidity and mortality in patients undergoing surgical repair of hip fractures. We conducted a propensity score matched retrospective analysis using de-identified data from the American College of Surgeons' National Surgical Quality Improvement Project (ACS NSQIP) for all patients undergoing hip fracture surgery over a 7 year period in hospitals across the United States enrolled in the ACS NSQIP with and without DNR status. We measured patient demographics including DNR status, co-morbidities, frailty and functional baseline, surgical and anaesthetic procedure data, post-operative morbidity/complications, length of stay, discharge destination and mortality. Of 9218 patients meeting the inclusion criteria, 13.6% had a DNR status, 86.4% did not. Mortality was higher in the DNR compared to the non-DNR group, at 15.3% vs 8.1% and propensity score matched multivariable analysis demonstrated that DNR status was independently associated with mortality (OR = 2.04, 95%CI: 1.46-2.86, P < 0.001). Additionally, analysis of the propensity score matched cohort ...Continue Reading

References

Apr 1, 1997·Anesthesia and Analgesia·M V Clemency, N J Thompson
Aug 17, 1999·Medical Care·L B ShepardsonG E Rosenthal
May 29, 2003·Critical Care Medicine·Jeffrey P BurnsRobert D Truog
Sep 1, 2005·CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne·Kenneth RockwoodArnold Mitnitski
Jan 18, 2006·Quality of Life Research : an International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation·Martin FortinAlain Vanasse
Oct 14, 2008·Surgery·Steven M SteinbergE Christopher Ellison
Jan 28, 2010·The American Journal of Medicine·Laura LoertscherPaul S Mueller
Feb 3, 2011·Journal of General Internal Medicine·Jacqueline K YuenMichael D Fetters
Mar 15, 2011·Journal of the American College of Surgeons·Mehul V RavalClifford Y Ko
Mar 25, 2011·Clinical Orthopaedics and Related Research·Jane A Cauley
Aug 29, 2013·Stroke; a Journal of Cerebral Circulation·Kazuma NakagawaJ Claude Hemphill
Oct 24, 2013·International Journal of Stroke : Official Journal of the International Stroke Society·Katri SilvennoinenTurgut Tatlisumak
Jun 5, 2014·Bone & Joint Research·J R BerstockA W Blom
Jun 18, 2014·BMC Geriatrics·José María Abad-DíezAlexandra Prados-Torres
Jul 19, 2014·World Journal of Orthopedics·Mathias OppererStavros G Memtsoudis
Dec 3, 2014·Injury·Vasanth SathiyakumarManish K Sethi
Mar 20, 2015·The Journal of Bone and Joint Surgery. American Volume·Bryce A BasquesJonathan N Grauer
Jun 25, 2015·International Orthopaedics·Jan SchmoldersSascha Gravius
Sep 16, 2015·JAMA : the Journal of the American Medical Association·Yannick Le ManachP J Devereaux
Jun 15, 2016·A & a Case Reports·Thomas R HickeyAngela M Bader
Mar 21, 2017·Anesthesia and Analgesia·Elisa C WalshRichard D Urman

❮ Previous
Next ❯

Citations

Jan 11, 2020·Anesthesia and Analgesia·Brooks V UdelsmanMatthew J Meyer
Feb 26, 2021·Current Opinion in Anaesthesiology·Christin Kim, Ryan Keneally
Jul 28, 2020·Best Practice & Research. Clinical Anaesthesiology·Tasneem F HasanAlan D Kaye
May 22, 2018·Journal of Clinical Anesthesia·Ethan Y BrovmanRichard D Urman

❮ Previous
Next ❯

Software Mentioned

R Project for Statistical Computing ( R
MatchIt

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.