Introduction: The Do Not Resuscitate (DNR) order aims to prevent futile interventions when the medical prognosis is poor. This study evaluates resource utilization by DNR patients in the Intensive Care Unit (ICU) and compares it with non-DNR patients, addressing a gap in research within Saudi Arabia. Methods: We conducted a retrospective analysis of 7,104 patients admitted to the ICU at King Abdullah Medical City, Makkah, from January 2016 to June 2023. Patients were categorized into DNR and non-DNR groups. Data were extracted from the critical care registry and analyzed descriptively. The chi-square test assessed resource utilization outcomes between the two groups post-DNR decision. Results: Among the 7,104 patients analyzed, 988 were classified as DNR, while 6,116 were non-DNR. Notably, DNR patients had a mean age of 61.4 years, significantly older than the non-DNR group at 55.9 years (p < 0.001). The mortality rate for DNR patients was markedly higher at 85.1%, compared to just 10.2% for non-DNR patients (p < 0.0001). Furthermore, DNR patients utilized a substantial amount of critical care resources, with 88.9% requiring mechanical ventilation versus 41.4% in the non-DNR group (p < 0.001), and 28.6% receiving Continuous Renal Replacement Therapy (CRRT) compared to 6.7% (p < 0.001). The mean length of ICU stay was also significantly longer for DNR patients at 20.4 days, in contrast to 8.0 days for non-DNR patients (p < 0.001). Additionally, a higher percentage of DNR patients received two or more antibiotics (76.1%) compared to 56.8% of non-DNR patients (p < 0.001). Conclusion: DNR patients consumed substantial healthcare resources post-DNR decision. Optimizing physician approaches toward DNR patients is essential to balance resource allocation and patient comfort in terminal cases.
Rugaan et al. (Sun,) studied this question.