Characteristics of residents with do-not-resuscitate orders in nursing homes
D. H. Mark, J. Bahr, E. H. Duthie and D. D. Tresch
Department of Family and Community Medicine, Medical College of Wisconsin, Milwaukee, USA.
We determined patient characteristics associated with do-not-resuscitate
(DNR) status in nursing homes using cross-sectional analysis of secondary
data derived from Minimum Data Set documents in 14 nursing homes from one
state in the upper Midwest. The primary outcome variable was DNR status.
Bivariate analysis was first carried out on all variables. Variables
associated with DNR status at this stage were then included in a stepwise
logistic regression to determine variables independently associated with
DNR status. Overall, 71% of patients had DNR orders. Variables found to be
independently associated with a higher probability of DNR status were
increasing age, female gender, worse cognitive function, durable power of
attorney, being self-paying, or having commercial insurance. Lack of daily
contact with relatives and friends and lack of involvement with others were
associated with lower probability of DNR status. A higher prevalence of DNR
status in nursing homes was seen than in prior literature. The patient
characteristics shown to be associated with DNR status may give important
insight into the reasons that such decisions are made.
