The effect of do-not-resuscitate status on postoperative mortality in the elderly following emergency surgery

Elderly patients who have preexisting DNR orders experience a high incidence of mortality and major morbidity within 30 days after emergency general surgery. Although not a risk factor for major morbidity, preoperative DNR status does represent an independent risk factor for mortality after emergency general surgery. The most plausible reason for the excess mortality in DNR patients is their decreased willingness to undergo aggressive treatment of major postoperative complications. Whether patient-driven failure-to-pursue-rescue also explains to some extent the high mortality of non-DNR elderly emergency general surgery patients deserves further investigation.