Advance directives and do-not-resuscitate orders on general medical wards versus the intensive care unit.
The records of 335 patients admitted to the general medicine wards and to the medical intensive and coronary care unit (MICCU) at Brooke Army Medical Center were retrospectively reviewed to assess the frequency of advance directives and "do not resuscitate" (DNR) designations. Two hundred sixty-seven (79.7%) were admitted to the ward and 68 (20.3%) were admitted to the MICCU. Advance directives were executed in 14.9% of patients. DNR designations were made for 21 (7.9%) patients on the ward and 11 (16.2%) patients in the MICCU (p = 0.064). There were no statistical differences in mean length of stay, presence of advance directives, or documentation of advance directives in ward versus MICCU patients. However, there was a statistical difference in the number of deaths in the MICCU as compared with that on the ward (9.7 vs. 2.7%, p < 0.05). The frequency of advance directives and DNR designations did not differ between ward and MICCU patients in this population, although there was a trend for greater DNR designations in the MICCU environment.
Kemp
Kenneth R
KR
Department of Medicine, Brooke Army Medical Center, Fort Sam Houston, TX 78234-6200, USA.
Emmons
Ethan
E
Hayes
Jackie
J
D016223:Advance Directives / Q000706:statistics & numerical data*; D000368:Aged; D005260:Female; D006772:Hospitals, Military; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D010362:Patients' Rooms; D011336:Probability; D016414:Resuscitation Orders; D013781:Texas