Lack of long term change in resuscitation practice after passage of the New York State DNR Law

Purpose: To evaluate the long term effect of NYS's DNR legislation on resuscitation practice in view of studies suggesting a minimal early effect. Method: Demographic and clinical data were collected in retrospective review of 100% of the charts of the 153 patients resuscitated in a community teaching hospital between December 1994 and June 1995. These data were compared with those from similar periods of 1987-88 (before passage of the NYS DNR law) and 1988-89 (just after passage). Results: Of the resuscitated patients in 1994-9519% were SNF residents, 30% carried a diagnosis of dementia, and 15% carried a diagnosis of malignancy. There were 0.029 resuscitations per admission, 0.032 per discharge, and 0.004 resuscitation per patient day. None of these values showed any change from the 1987-88 and 1988-89 study periods. Conclusions: Little change in the characteristics or size of the patient population subjected to resuscitation seems to have occurred subsequent to passage of the NYS DNR Law, even after several years. Clinical Implication: Care givers should re-evaluate their preparation for the possible occurrence of cardiopulmonary arrest, especially in the group of patients who are unable to express their own wishes.