help button home button
AJRCCM
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
This Article
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Rapoport, J.
Right arrow Articles by Lemeshow, S.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Rapoport, J.
Right arrow Articles by Lemeshow, S.

Am. J. Respir. Crit. Care Med., Vol 153, No. 1, Jan 1996, 185-190.

Resource use implications of do not resuscitate orders for intensive care unit patients

J Rapoport, D Teres and S Lemeshow
Department of Economics, Mount Holyoke College, South Hadley, Baystate Medical Center, Springfield, Massachusetts 01075, USA.

This study describes the use of do not resuscitate (DNR) orders for ICU patients in four northeastern U.S. teaching hospitals and investigates the relationship between DNR orders and length of stay. The use of detailed data from the mortality probability model (MPM II) study on 6,290 consecutive ICU admissions to general adult medical and surgical ICUs during 1989 through 1991 allows us to control for severity of illness and the time during the ICU stay at which the DNR order was entered. About 12.8% of patients were DNR during their ICU stay, including more than half of nonsurvivors. The percentage of patients with DNR was higher for older and more severely ill patients. Most DNR orders were issued after 72 h in the ICU, but many were issued during the first ICU day. Nonsurvivors with early (first 24 h) DNR had shorter mean and median ICU and hospital stays than the comparison group of non- DNR patients. The percentage of patients with very long ICU (> 30 d) and hospital (> 60 d) stays was smaller among DNR patients. The use of DNR orders, particularly early in the ICU stay, may be associated with significant resource use reduction for an identifiable group of patients.


This article has been cited by other articles:


Home page
 Am J Crit CareHome page
D. Cook, G. Rocker, J. Marshall, L. Griffith, E. McDonald, G. Guyatt, and for the Level of Care Study Investigators and the
Levels of Care in the Intensive Care Unit: A Research Program
Am. J. Crit. Care., May 1, 2006; 15(3): 269 - 279.
[Abstract] [Full Text] [PDF]

Home page
 Canadian J. AnesthesiaHome page
T. Sinuff, D. J. Cook, G. M. Rocker, L. E. Griffith, S. D. Walter, M. M. Fisher, P. M. Dodek, P. Sjokvist, E. McDonald, J. C. Marshall, et al.
DNR directives are established early in mechanically ventilated intensive care unit patients: [Les directives PDR sont etablies tot chez les patients sous ventilation mecanique a l'unite des soins intensifs]
Can J Anesth, December 1, 2004; 51(10): 1034 - 1041.
[Abstract] [Full Text] [PDF]

Home page
 Int J Qual Health CareHome page
Y. Arabi, S. Venkatesh, S. Haddad, S. Al Malik, and A. Al Shimemeri
The characteristics of very short stay ICU admissions and implications for optimizing ICU resource utilization: the Saudi experience
Int. J. Qual. Health Care, April 1, 2004; 16(2): 149 - 155.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
J. M. LUCE and G. D. RUBENFELD
Can Health Care Costs Be Reduced by Limiting Intensive Care at the End of Life?
Am. J. Respir. Crit. Care Med., March 15, 2002; 165(6): 750 - 754.
[Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Proc. Am. Thorac. Soc. Am. J. Respir. Cell Mol. Biol.
Copyright © 1996 American Thoracic Society