Do-Not-Resuscitate Orders among Trauma Patients
Document Type
Article
Publication Date
12-2015
Abstract
Background
Do-not-resuscitate (DNR) orders are an important means to communicate end-of-life wishes. Previous studies have demonstrated variable prevalence of DNR orders among hospitalized trauma patients.
Objective
This study was conducted to identify the prevalence and type of DNR orders among trauma patients and to identify associations of DNR orders with injury severity, length of stay, and whether CPR was performed in cases of cardiac arrest.
Methods
In this retrospective study, medical records were reviewed for 263 trauma patients at Miami Valley Hospital in Dayton, Ohio, in 2014 with a DNR order.
Results
Among 3394 trauma patients in 2014, 263 (8%) patients had a DNR order. Participants were 43% male and 57% female. The mean age was 76 (range, 16-90 +) years. The most common mechanisms of injury included fall (n = 214, 81.4%) and motor vehicle collision (n = 16, 6.1%). Most DNR orders in this patient population were instituted during the hospitalization (n = 176, 67%). The most common types of advance directives included DNR order (n = 224, 85.2%), living will (n = 124, 47.2%), and durable power of health care attorney (n = 126, 47.9%). A minority of patients died during hospitalization (n = 100, 38.0%). Among patients who were deceased, 14 (14.0%) had CPR performed.
Conclusions
Among trauma patients with DNR orders, most DNR orders were instituted during the hospital admission. Most deceased patients with DNR orders did not have CPR performed during the hospital stay.
Repository Citation
Marco, C. A.,
Michael, S. A.,
Bleyer, J. E.,
& Post, A. M.
(2015). Do-Not-Resuscitate Orders among Trauma Patients. The American Journal of Emergency Medicine, 33 (12), 1770-1772.
https://corescholar.libraries.wright.edu/emergency_medicine/75
DOI
10.1016/j.ajem.2015.08.026
