title: Do not resuscitate orders for patients with intracerebral hemorrhage: experience from a Chinese tertiary care center.
abstract: OBJECTIVE
  This study aimed to determine the frequency and determinant factors of do not resuscitate (DNR) orders in patients with intracerebral hemorrhage (ICH) at a university hospital in China.
  
  
  METHODS
  Data collected from June 2010 to December 2012 for patients with ICH were retrospectively reviewed. The characteristics and care of patients with and without DNR orders and those with early (≤24 h) and late (>24 h) DNR establishment were compared.
  
  
  RESULTS
  Formal DNR orders were filed during hospitalization for 64/759 (8.4%) patients with complete medical records enrolled in this study. Patients with DNR orders were older on average (73.1 ± 10.1 vs. 56.0 ± 13.2 years; p < 0.001) and a larger proportion had pre-ICH comorbidity impacting dependency (87.5 vs. 17.0%; p < 0.001) than did those with no DNR order. Patients with DNR orders were in worse clinical condition on arrival than those without a DNR order, as judged by Glasgow Coma Scale scores, and more frequently had large hematoma volumes (78.1 vs. 39.7%; p < 0.001).
  
  
  CONCLUSIONS
  DNR orders were not used commonly for patients with ICH in this Chinese sample. No relationship between ICH severity and DNR decision making was observed.
authors.affiliation: Emergency Department, Beijing Tiantan Hospital, Capital Medical University/Beijing Neurosurgical Institute, China.
authors.forename: Tie-Cheng
authors.initials: TC
authors.lastname: Yang
authors.forename: Jian-Guo
authors.initials: JG
authors.lastname: Li
authors.forename: Wei
authors.initials: W
authors.lastname: Guo
mesh_terms: D000328:Adult; D000368:Aged; D002543:Cerebral Hemorrhage / Q000453:epidemiology* / Q000628:therapy*; D002681:China; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016414:Resuscitation Orders; D012189:Retrospective Studies; D062606:Tertiary Care Centers