New Insights on DNR Orders in Elderly Surgical Patients

In older adults undergoing surgery, new Do Not Resuscitate (DNR) orders often indicate significant risk factors and timing that can guide surgical decision-making.

• Only 2.3% of 47,564 cases resulted in new perioperative DNR orders.
• Key predictors of DNR orders: ASA IV/V (2.6x), disseminated cancer (3.3x), and emergent surgery (3.5x).

DNR orders typically occur early post-surgery; 32.5% were placed within 24 hours.

• Among patients who died, DNR was commonly set 5.2 days prior to death, emphasizing a need for prompt goals-of-care conversations.