Postoperative outcomes in patients with a do-not-resuscitate (DNR) order undergoing elective procedures

Journal of Clinical Anesthesia
Ethan Y BrovmanRichard D Urman

Abstract

Do-not-resuscitate (DNR) status has been shown to be an independent risk factor for mortality in the post-operative period. Patients with DNR orders often undergo elective surgeries to alleviate symptoms and improve quality of life, but there are limited data on outcomes for informed decision making. Retrospective cohort study. A multi-institutional setting including operating room, postoperative recovery area, inpatient wards, and the intensive care unit. A total of 566 patients with a DNR status and 316,431 patients without a DNR status undergoing elective procedures using the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) from 2012. Patients undergoing elective surgical procedures. We analyzed the risk-adjusted 30-day morbidity and mortality outcomes for the matched DNR and non-DNR cohorts undergoing elective surgeries. DNR patients had significantly increased odds of 30-day mortality (OR 2.51 [1.55-4.05], p < 0.001) compared with non-DNR patients. In the DNR versus non-DNR cohort there was no significant difference in the occurrence of a number of 30-day complications, the rate of resuscitative measures undertaken, including cardiac arrest requiring CPR, reintubation, or return to the...Continue Reading

References

Jan 20, 1999·Journal of General Internal Medicine·L B ShepardsonG E Rosenthal
Aug 17, 1999·Medical Care·L B ShepardsonG E Rosenthal
Oct 3, 2002·Journal of Medical Ethics·E P Cherniack
May 29, 2003·Critical Care Medicine·Jeffrey P BurnsRobert D Truog
Oct 14, 2008·Surgery·Steven M SteinbergE Christopher Ellison
Nov 10, 2009·Behavior Research Methods·Franz FaulAlbert-Georg Lang
Jan 28, 2010·The American Journal of Medicine·Laura LoertscherPaul S Mueller
Mar 13, 2012·Anesthesiology Clinics·Thomas H Scott, Jonathan R Gavrin
Jul 15, 2015·Annals of Vascular Surgery·Jeffrey J SiracuseAndrew J Meltzer
Oct 28, 2015·The Journal of Surgical Research·Kazuhide MatsushimaScott B Armen
Jun 15, 2016·A & a Case Reports·Thomas R HickeyAngela M Bader
Mar 21, 2017·Anesthesia and Analgesia·Elisa C WalshRichard D Urman
Jan 10, 2018·World Journal of Orthopedics·Ethan Y BrovmanRichard D Urman

❮ Previous
Next ❯

Citations

Jul 4, 2020·Southern Medical Journal·Rebecca EngelsAnnie Massart
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
Jun 1, 2021·Frontiers in Public Health·Hala SultanMaysa Al-Hussaini
Aug 1, 2021·Journal of the American Geriatrics Society·Hadiza S KazaureKimberly S Johnson

❮ Previous
Next ❯

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.