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Do‐Not‐Resuscitate Orders in an Extended‐Care Study Group
Author(s) -
Meyers Roberta M.,
Lurie Nicole,
Breitenbucher Robert B.,
Waring Christine J.
Publication year - 1990
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.1990.tb04425.x
Subject(s) - medicine , do not resuscitate order , resuscitation orders , do not resuscitate , family medicine , intensive care medicine , emergency medicine , cardiopulmonary resuscitation , resuscitation
We examined the charts of 911 nursing home patients in Hennepin County, Minnesota, to determine the prevalence of written do‐not‐resuscitate (DNR) orders. Information regarding demographic characteristics, and whether a surrogate decisionmaker was available and participated in the decision, was also collected. Twenty‐seven percent of patients had DNR orders. Ninety percent of all patients had potentially available surrogate decisionmakers. However, for 31% of patients with DNR orders, there was no documentation of patient or surrogate participation in the DNR decision. Univariate analysis identified female sex, increased age, level of care (skilled versus intermediate), presence of a potential surrogate decisionmaker, and increasing length of time since nursing home admission as factors associated with presence of DNR orders. When a logistic regression model was used, increased age, increased length of time since nursing home admission, skilled versus intermediate level of care, and presence of a surrogate decisionmaker were independently associated with presence of DNR status. Several variables are independently associated with written DNR orders; their relationship to the factors physicians use in decision making requires further study.