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Sociodemographic Factors Associated with Do-Not-Resuscitate Order Utilization in the Surgical Intensive Care Unit: An
Ziya Zhang1, Alan Weinberg1, Anna Hackett1
1Institute for Critical Care Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Sociodemographic factors like age and religion significantly influence do-not-resuscitate (DNR) order selection in the Surgical Intensive Care Unit (SICU). Understanding these factors is crucial for sensitive end-of-life care discussions.
Area of Science:
- Medical Ethics
- Critical Care Medicine
- Sociology of Health
Background:
- Do-not-resuscitate (DNR) orders are vital for end-of-life care planning.
- Patient and family engagement in these decisions is complex.
- Understanding influencing factors is key to improving care.
Purpose of the Study:
- To investigate sociodemographic factors associated with DNR order selection.
- To examine the assignment of healthcare proxies in the SICU.
- To analyze trends in DNR utilization over time.
Main Methods:
- Retrospective chart review of 312 deceased patients in the SICU over 7 years.
- Analysis of associations between sociodemographic variables and DNR selection.
- Statistical analysis to identify independent factors influencing DNR orders.
Main Results:
- Year of admission, patient age, religion, and healthcare proxy status were independently associated with DNR selection.
- A significant increase in DNR selection was observed from 2012 to 2019.
- Relative chance of DNR selection in 2019 vs. 2012 was 3.538 (P < .01).
Conclusions:
- Sociodemographic factors significantly impact DNR order utilization in the SICU.
- Healthcare providers must consider patients' social and religious backgrounds during end-of-life discussions.
- Further research is needed to explore these factors in surviving patients.
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