The epidemiology of do-not-resuscitate orders in patients with trauma: a community level one trauma center observational experience

Do-Not-Resuscitate (DNR) orders in patients with traumatic injury are insufficiently described. The objective is to describe the epidemiology and outcomes of DNR orders in trauma patients. We included all adults with trauma to a community Level I Trauma Center over 6 years (2008-2013). We used chi-s...

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Bibliographic Details
Published in:Scandinavian journal of trauma, resuscitation and emergency medicine resuscitation and emergency medicine, 2015-02, Vol.23 (1), p.9-9, Article 9
Main Authors: Salottolo, Kristin, Offner, Patrick J, Orlando, Alessandro, Slone, Denetta S, Mains, Charles W, Carrick, Matthew, Bar-Or, David
Format: Article
Language:English
Subjects:
Adult
Age
Age Factors
Aged
Analysis
Cardiac arrhythmia
Care and treatment
Coma
Comorbidity
Complications and side effects
Do-not-resuscitate orders
Emergency medical services
Female
Glasgow Coma Scale
Hospital Mortality
Hospitals
Humans
Hypotension
Intubation
Male
Medical prognosis
Middle Aged
Mortality
Original Research
Palliative care
Patient education
Patient outcomes
Patients
Regression analysis
Resuscitation Orders
Risk factors
Sex Factors
Stroke
Time Factors
Trauma
Trauma centers
Trauma Centers - organization & administration
Traumatic brain injury
Wounds and Injuries - mortality
Wounds and Injuries - therapy
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Summary:Do-Not-Resuscitate (DNR) orders in patients with traumatic injury are insufficiently described. The objective is to describe the epidemiology and outcomes of DNR orders in trauma patients. We included all adults with trauma to a community Level I Trauma Center over 6 years (2008-2013). We used chi-square, Wilcoxon rank-sum, and multivariate stepwise logistic regression tests to characterize DNR (established in-house vs. pre-existing), describe predictors of establishing an in-house DNR, timing of an in-house DNR (early [within 1 day] vs late), and outcomes (death, ICU stay, major complications). Included were 10,053 patients with trauma, of which 1523 had a DNR order in place (15%); 715 (7%) had a pre-existing DNR and 808 (8%) had a DNR established in-house. Increases were observed over time in both the proportions of patients with DNRs established in-house (p = 0.008) and age ≥65 (p 
ISSN:1757-7241
1757-7241
DOI:10.1186/s13049-015-0094-2