Key result
Early do-not-resuscitate orders were associated with a lower risk of 30-day unplanned readmission after pneumonia hospitalization (20.0% vs. 22.5%; aOR 0.93, 95% CI 0.88-0.99).
Why the study?
Associations between patient do-not-resuscitate (DNR) status and 30-day readmissions after pneumonia were unclear, despite pneumonia readmission rates being a national quality measure.
Does early DNR status reduce 30-day unplanned readmissions in patients hospitalized for pneumonia?
Cohort (n=68,691)
Yes
Does early DNR status reduce 30-day unplanned readmissions in patients hospitalized for pneumonia?
Odds Ratio: 0.93 (95% CI 0.88–0.99)
Absolute Event Rate: 20% vs 22.5%
Early DNR status is associated with a lower risk of 30-day readmission after pneumonia, and including it in risk-adjustment models alters readmission ratings for a small number of hospitals.
Supports adjusting pneumonia readmission models for early DNR; leaves open causality and generalizability in observational data.
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Mehta et al. (2016) conducted a cohort in Pneumonia (n=68,691). Early do-not-resuscitate (DNR) orders vs. No early DNR order was evaluated on 30-day unplanned readmission (aOR 0.93, 95% CI 0.88-0.99). Early do-not-resuscitate orders were associated with a lower risk of 30-day unplanned readmission after pneumonia hospitalization (20.0% vs. 22.5%; aOR 0.93, 95% CI 0.88-0.99).
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