{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T13:55:26Z","timestamp":1777384526877,"version":"3.51.4"},"reference-count":25,"publisher":"SAGE Publications","issue":"12","license":[{"start":{"date-parts":[[2022,5,5]],"date-time":"2022-05-05T00:00:00Z","timestamp":1651708800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Hosp Palliat Care"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:p>The role of early Do Not Resuscitate (DNR) in hospitalized older adults (OAs) with SARS-CoV-2 infection is unknown. The objective of the study was to identify characteristics and outcomes associated with early DNR in hospitalized OAs with SARS-CoV-2. We conducted a retrospective chart review of older adults (65+) hospitalized with COVID-19 in New York, USA, between March 1, 2020, and April 20, 2020. Patient characteristics and hospital outcomes were collected. Early DNR (within 24 hours of admission) was compared to non-early DNR (late DNR, after 24 hours of admission, or no DNR). Outcomes included hospital morbidity and mortality. Of 4961 patients, early DNR prevalence was 5.7% (n = 283). Compared to non-early DNR, the early DNR group was older (85.0 vs 76.8,\u00a0 P\u00a0&lt; .001), women (51.2% vs 43.6%,\u00a0 P\u00a0= .012), with higher comorbidity index (3.88 vs 3.36,\u00a0 P\u00a0&lt; .001), facility-based (49.1% vs 19.1%,\u00a0 P &lt; .001), with dementia (13.3% vs 4.6%,\u00a0 P\u00a0&lt; .001), and severely ill on presentation (57.9% vs 32.3%,\u00a0 P\u00a0&lt; .001). In multivariable analyses, the early DNR group had higher mortality risk (OR: 2.94, 95% CI: 2.10\u20134.11), less hospital delirium (OR: 0.55, 95% CI: 0.40\u2013.77), lower use of invasive mechanical ventilation (IMV, OR: 0.37, 95% CI: .21\u2013.67), and shorter length of stay (LOS, 4.8 vs 10.3 days,\u00a0 P\u00a0&lt; .001), compared to non-early DNR. Regarding early vs late DNR, while there was no difference in mortality (OR: 1.12, 95% CI: 0.85\u20131.62), the early DNR group experienced less delirium (OR: 0.55, 95% CI: .40\u2013.75), IMV (OR: 0.53, 95% CI: 0.29\u2013.96), and shorter LOS (4.82 vs 10.63 days, OR: 0.35, 95% CI: 0.30\u2013.41). In conclusion, early DNR prevalence in hospitalized OAs with COVID-19 was low, and compared to non-early DNR is associated with higher mortality but lower morbidity.<\/jats:p>","DOI":"10.1177\/10499091221084653","type":"journal-article","created":{"date-parts":[[2022,5,5]],"date-time":"2022-05-05T08:00:32Z","timestamp":1651737632000},"page":"1491-1498","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Early DNR in Older Adults Hospitalized with SARS-CoV-2 Infection During Initial Pandemic Surge"],"prefix":"10.1177","volume":"39","author":[{"given":"Shalin","family":"Shah","sequence":"first","affiliation":[{"name":"Division of Hospital Medicine, Department of Medicine, Northwell Health, Manhasset, NY, USA"},{"name":"Donald and Barbara Zucker School of Medicine at Hofstra\/Northwell, Northwell Health, Hempstead, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alex","family":"Makhnevich","sequence":"additional","affiliation":[{"name":"Division of Hospital Medicine, Department of Medicine, Northwell Health, Manhasset, NY, USA"},{"name":"Donald and Barbara Zucker School of Medicine at Hofstra\/Northwell, Northwell Health, Hempstead, NY, USA"},{"name":"Center for Health Innovations and Outcomes Research, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica","family":"Cohen","sequence":"additional","affiliation":[{"name":"Division of Hospital Medicine, Department of Medicine, Northwell Health, Manhasset, NY, USA"},{"name":"Donald and Barbara Zucker School of Medicine at Hofstra\/Northwell, Northwell Health, Hempstead, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meng","family":"Zhang","sequence":"additional","affiliation":[{"name":"Center for Health Innovations and Outcomes Research, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Allison","family":"Marziliano","sequence":"additional","affiliation":[{"name":"Center for Health Innovations and Outcomes Research, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Qiu","sequence":"additional","affiliation":[{"name":"Center for Health Innovations and Outcomes Research, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yan","family":"Liu","sequence":"additional","affiliation":[{"name":"Center for Health Innovations and Outcomes Research, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael A.","family":"Diefenbach","sequence":"additional","affiliation":[{"name":"Center for Health Innovations and Outcomes Research, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Carney","sequence":"additional","affiliation":[{"name":"Donald and Barbara Zucker School of Medicine at Hofstra\/Northwell, Northwell Health, Hempstead, NY, USA"},{"name":"Division of Geriatrics and Palliative Medicine, Department of Medicine, Northwell Health, Manhasset, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edith","family":"Burns","sequence":"additional","affiliation":[{"name":"Donald and Barbara Zucker School of Medicine at Hofstra\/Northwell, Northwell Health, Hempstead, NY, USA"},{"name":"Center for Health Innovations and Outcomes Research, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA"},{"name":"Division of Geriatrics and Palliative Medicine, Department of Medicine, Northwell Health, Manhasset, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9700-251X","authenticated-orcid":false,"given":"Liron","family":"Sinvani","sequence":"additional","affiliation":[{"name":"Division of Hospital Medicine, Department of Medicine, Northwell Health, Manhasset, NY, USA"},{"name":"Donald and Barbara Zucker School of Medicine at Hofstra\/Northwell, Northwell Health, Hempstead, NY, USA"},{"name":"Center for Health Innovations and Outcomes Research, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2022,5,5]]},"reference":[{"key":"bibr1-10499091221084653","unstructured":"U.S. Department of Health and Human Services: Centers for Disease Control and Prevention. 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