Department of Health Policy and Administration, College of Health and Human Development, The Pennsylvania State University, 604E Donald H. Ford Building, University Park, PA 16802 United States.
School of Nursing, The Pennsylvania State University, University Park, PA, United States.
Heart Lung. 2020 Nov-Dec;49(6):812-816. doi: 10.1016/j.hrtlng.2020.09.012. Epub 2020 Oct 1.
Readmissions for patients with heart failure (HF) continues to be a target of value-based purchasing initiatives. Do-not-resuscitate (DNR) orders-one part of advance care planning (ACP)-have been shown to be related to other patient outcomes but has not been explored as a risk factor for HF readmission.
Examine the association between DNR and 30-day readmissions among elderly patients with HF admitted to hospitals in Pennsylvania.
Data included hospital discharges from 2011 to 2014 of patients 65+ years with a primary diagnosis of HF. Logistic regression was used to model the relationship between DNR and 30-day readmission.
Among 107,806 patients, 20.9% were readmitted within 30 days. After controlling for covariates, patients with HF who had a DNR were less likely to be readmitted to the hospital (OR=0.85, 95% CI: 0.80-0.91, p<0.001).
Documentation of a DNR may inform efforts to reduce readmissions among elderly patients with HF.
心力衰竭（HF）患者的再入院仍然是基于价值的购买计划的目标。 不复苏（DNR）医嘱 - 预先护理计划（ACP）的一部分 - 已被证明与其他患者结局有关，但尚未作为 HF 再入院的危险因素进行探讨。
检查宾夕法尼亚州医院收治的老年 HF 患者的 DNR 与 30 天再入院之间的关联。
数据包括 2011 年至 2014 年期间 65 岁以上有 HF 主要诊断的患者的医院出院记录。使用逻辑回归来模拟 DNR 与 30 天再入院之间的关系。
在 107806 名患者中，20.9％在 30 天内再次入院。在控制了混杂因素后，有 DNR 的 HF 患者再次入院的可能性较小（OR=0.85，95％CI：0.80-0.91，p<0.001）。
DNR 的记录可能为减少老年 HF 患者的再入院提供信息。
