DNAR Orders Improve Care for Patients Over 85 Without Raising Mortality Risks

A new study published in BMC Geriatrics has examined the impact of do-not-attempt-resuscitation (DNAR) orders on extremely elderly patients. The research focused on those aged 85 and above, a demographic that is expanding rapidly worldwide. Findings suggest these orders help streamline medical care while respecting patient preferences and quality of life. The retrospective cohort study analysed non-critically ill patients with DNAR orders. Results showed that such patients generally underwent fewer invasive procedures and had shorter hospital stays. This led to a more efficient use of healthcare resources without increasing in-hospital mortality rates.

The study also revealed that DNAR orders are not a predictor of imminent death. Instead, they reflect individual risk profiles and a shift towards comfort-focused care. Patients with these orders often had varied chronic conditions, highlighting the need for personalised treatment plans. Researchers emphasised the role of advanced care planning in routine geriatric assessments. They noted that DNAR decisions usually involve discussions between patients, families, and medical teams, ensuring patient autonomy is respected. The study further explored cultural influences on these decisions, particularly in Japan, where medical ethics frameworks must account for local values. Beyond resuscitation preferences, DNAR orders were found to encourage broader conversations about care goals and end-of-life planning. This often resulted in fewer unnecessary hospital admissions and better alignment with patients’ wishes.

The findings provide valuable insights into end-of-life care for the extremely elderly. DNAR orders appear to support more efficient resource use while maintaining patient-centred care. The study calls for greater integration of advanced care planning in geriatric medicine to improve communication and respect for patient choices.