Do-Not-Resuscitate Orders and Outcomes for Patients with Pancreatic Cancer

Area of Science:

• Oncology
• Healthcare Economics
• Palliative Care

Background:

• The impact of do-not-resuscitate (DNR) orders on pancreatic cancer patients' outcomes is not well understood.
• This study investigates the association between DNR status and in-hospital mortality and costs for pancreatic cancer patients.

Purpose of the Study:

• To evaluate the relationship between do-not-resuscitate (DNR) status and in-hospital mortality among pancreatic cancer patients.
• To assess the association between DNR status and inpatient costs for pancreatic cancer patients.

Main Methods:

• Utilized data from the National Inpatient Sample (NIS) of the Healthcare Cost and Utilization Project (HCUP).
• Included 40,246 pancreatic cancer admissions between 2011 and 2016.
• Employed logistic regression for mortality and multivariable generalized linear regression for inpatient costs.

Main Results:

• 15% of patients had a documented DNR order.
• DNR orders were associated with a nearly sixfold increase in mortality risk (OR 5.90, p < 0.0001).
• Patients with DNR who died had lower costs (-$983, p=0.0270), while those who died without DNR had higher costs (+$5638, p < 0.0001).
• DNR status did not significantly affect costs for patients discharged alive.

Conclusions:

• Do-not-resuscitate (DNR) orders in pancreatic cancer patients correlate with increased mortality risk.
• DNR status is linked to reduced inpatient costs for patients who die during hospitalization.
• DNR status does not appear to influence costs for pancreatic cancer patients who survive hospitalization.