Patients with DNR orders may face poorer outcomes

Patients who have signed do-not-resuscitate (DNR) orders may have a higher chance of dying after surgery--depending on the surgery, according to a new study appearing in the Archives of Surgery.

In the study, researchers compared clinical information for 4,128 adults with DNR orders with a group of 4,128 individuals without DNR orders. They were all all age-matched and procedure-matched and had surgery at one of 120 U.S. hospitals between 2005 to 2008.

Many of the individuals with DNR orders (63 percent) had non-emergency surgical procedures. However, regardless of the urgency of the procedure, the study found that those with DNR orders were at least two times more likely to die soon after surgery.

In addition, nearly one-fourth of the DNR patients died within the month following their surgery, which was about three times as much as in the comparison group, researcher Saziana Roman, MD, of the Yale School of Medicine, told Reuters Health.

The outcome, though, depended on the type of surgery. For example, about half patients with DNRs having exploratory laparotomies died within a month of the surgery--compared with one in five of the patients without DNRs.

However, for surgeries such as thighbone fracture repair or appendectomies, no differences were reported between the two patient groups.

Overall, DNR patients "may have surgery to gain 'additional time,'" the study researchers noted. However, as the study indicates, that may not be occurring with various surgeries.

For more details:
- see the Archives of Surgery abstract
- read the Reuters Health article
- read the HealthDay News story

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