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Higher 30-Day Mortality for Surgery Patients With DNR

By Joyce Frieden, News Editor, MedPage Today

Published: April 20, 2011

Reviewed by Dori F. Zaleznik, MD; Associate Clinical Professor of Medicine, Harvard Medical School, Boston and Dorothy Caputo, MA, RN, BC-ADM, CDE, Nurse Planner

Action Points

• Explain that a study found a higher rate of surgical complications and death among patients with a "do not resuscitate" order within 30 days of the procedure compared with matched controls who were not DNR.
• Note that even surgery classified as nonemergent resulted in more deaths within 30 postoperative days among those with a DNR order; reasons for surgery were not captured in the database used.

Patients with "do not resuscitate" (DNR) orders are more likely to die within 30 days of surgery, independent of other factors, a new study has found.
Compared with non-DNR patients, more than twice as many DNR patients died within 30 days of surgery (8.4% versus 23.1%, P<0 .001=".001" and="and" at="at" colleagues="colleagues" em="em" in="in" md="md" online="online" reported="reported" roman="roman" sanziana="sanziana" university="university" yale="yale">Archives of Surgery
. As well, the DNR patients were more likely to die no matter what surgical procedure was performed (35.5% versus 17.8%, and 16.6% versus 5.5% for emergent and nonemergent procedures, respectively, P<0 .001=".001" all="all" for="for" p="p">.