• J Am Med Dir Assoc · Jan 2005

    Predictors of do not resuscitate orders in the nursing home.

    • Barbara J Messinger-Rapport and Hosam K Kamel.
    • Section of Geriatric Medicine, Cleveland Clinic Foundation, Cleveland, OH 44195, USA. Rapporb@ccf.org
    • J Am Med Dir Assoc. 2005 Jan 1;6(1):18-21.

    BackgroundThe outcome of cardiopulmonary resuscitation of residents of long-term care facilities is poor. However, only about one half of residents of long term care facilities have a do not resuscitate (DNR) order. The remainder usually have resuscitation by order or by default policy. Understanding predictors of DNR may help clinicians address end-of-life issues with the older long-term care population.ObjectivesTo determine (1) the prevalence of DNR orders, and (2) predictors of DNR orders in older institutionalized individuals in a large community teaching nursing home.MethodsA cross-sectional chart review study of 177 consecutively located older patients from an 899-bed academic long-term care facility.ResultsThe prevalence of a DNR order was 40%. The frequency of ordering DNR was greater in subjects who were 85 years or older compared with subjects who were younger than 85 years (57% vs. 30%, P < .05). Ordering DNR was associated significantly with race (49% of whites compared with 13% African Americans, P < .05) but not with sex. Subjects with a DNR order were more likely to have been diagnosed with depression (52% vs. 35%, P < .05) but not dementia, and overall had greater number of medical conditions (5.9 +/- 2 vs. 5.1 +/- 2, P < .05) compared with subjects without DNR orders. The frequency of DNR orders did not significantly differ between subjects who were able to ambulate (with or without assistance) compared with subjects who were wheelchair or bed bound. Using logistic regression analysis, only age (with a B of -1.04 and P of .017) and race (with a B of 1.4 and a P of .01) were independent predictors of DNR status.ConclusionFewer than half of this sample of long-term care residents had a DNR order. Among seven factors studied, only age and race were independent predictors of DNR status in the nursing home.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…