Impact of the DNR therapeutic plan on patient care requirements.
BACKGROUND
The intensity and nature of a patient therapeutic plan should depend upon the specific therapeutic goals. When the therapeutic plan includes a do-not-resuscitate order, the intensity of the plan may be high or low.


OBJECTIVE
To examine the differences in patient care requirements and hospital outcomes in patients with a do-not-resuscitate status to determine the most appropriate care setting, eg, intensive vs nonintensive care.


METHODS
Data from a prospective sample of 100 patients were analyzed. Patients were grouped according to the intensity of the therapeutic plan: (1) all-but-CPR: all support except cardiopulmonary resuscitation, (2) conservative-care: medical management without the addition of life-sustaining measures, (3) comfort-only, and (4) withdrawal of life-sustaining therapy.


RESULTS
Patient mortality was high for all groups except the conservative-care group. Patient care requirements remained high in the all-but-CPR group, necessitating continued intensive care. Patient care requirements decreased significantly in the comfort-only and withdrawal groups, illustrating the ability to manage these patients in a nonintensive care setting.
Detroit Receiving Hospital, MI 48201.
M L
ML
Campbell
M
M
Thill-Baharozian
D000368:Aged; D003422:Critical Care; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D007902:Length of Stay; D008297:Male; D010347:Patient Care Planning; D018579:Patient Selection; D011446:Prospective Studies; D016414:Resuscitation Orders; D012720:Severity of Illness Index; D016896:Treatment Outcome; D028761:Withholding Treatment