Patients with DNR Orders May Face Poorer Outcomes

In a new study appearing in the Archives of Surgery, those with do not resuscitate orders (DNR) were at least two times more likely to die soon after surgery. Researchers compared clinical information for 4,128 adults with DNR orders with a group of 4,128 individuals without DNR orders. They were all all age-matched and procedure-matched and had surgery at one of 120 U.S. hospitals between 2005 to 2008.

Nearly one-fourth of the DNR patients died within the month following their surgery. The outcome depended on the type of surgery. For example, about half patients with DNRs having exploratory laparotomies died within a month of the surgery–compared with one in five of the patients without DNRs. However, for surgeries such as thighbone fracture repair or appendectomies, no differences were reported between the two patient groups.

I was grappling with the implications here. What were the researchers trying to say? Do not have a DNR? Do not have surgery?ξ

Then I read some of the comments to the original article at Reuters. Here are two perspectives.

“DNR is code for äóìDo Not Bother.äó There are plenty of doctors who feel that some patients, especially terminal ones are not worth the bother. Which is why they die more often.”
“By signing a DNR may have put the patients in a mindset that äóìIäó»m going to dieäó. Perhaps the äóÖfightäó» was taken out of them.”

What do you think?