Effect of do-not-resuscitate orders on patients with sepsis in the medical intensive care unit: A retrospective, observational and propensity score-matched study in a tertiary referral hospital in Taiwan
BMJ Open Jun 20, 2019
Chang YC, et al. - Via performing a retrospective observational study that included 717 consecutive adult intensive care patients, researchers determined whether do-not-resuscitate (DNR) orders affected outcomes in patients with sepsis admitted to the intensive care unit (ICU). Patients were divided into two groups: those without DNR orders (n=455) and those with DNR orders (n=262). Patients in the DNR group were further subclassified into early (orders signed on intensive care day 1, n=126) and late (signed after day 1, n=136) groups. The investigators found that, even after propensity-score matching, patients in the DNR group had worse mortality at days 7, 14, and 28. Furthermore, compared with late-DNR orders, those with early-DNR orders had better outcomes despite higher Charlson Comorbidity Index in the emergency room. Overall, DNR orders may predict suboptimal outcomes for patients with sepsis admitted to the ICU. The survival rate in the patients with early-DNR orders was not inferior to those with late-DNR orders.
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