{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T20:31:35Z","timestamp":1787776295005,"version":"build-2784847793"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Practices of Do-Not-Resuscitate (DNR) orders show discrepancies worldwide, but there are only few such studies from Saudi Arabia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To describe the practice of DNR orders in a Saudi Arabian tertiary care ICU.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This retrospective study included all patients who died with a DNR order at the ICU of King Saud Medical City, Riyadh, Saudi Arabia, between January 1 to December 31, 2021. The percentage of early DNR (i.e., \u226448 hours of ICU admission) and late DNR (&gt;48 hours) orders were determined and the variables between the two groups were compared. The determinants of late DNR were also investigated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A total of 723 cases met the inclusion criteria, representing 14.9% of all ICU discharges and 63% of all ICU deaths during the study period. The late DNR group comprised the majority of the cases (78.3%), and included significantly more patients with acute respiratory distress syndrome (ARDS), community acquired pneumonia (CAP), acute kidney injury, and COVID-19, and significantly fewer cases of readmissions and malignancies. Septic shock lowered the odds of a late DNR (OR = 0.4, 95% CI: 0.2\u20130.9;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.02), while ARDS (OR = 3.3, 95% CI: 2\u20135.4;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001), ischemic stroke (OR = 2.5, 95% CI: 1.1\u20135.4;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.02), and CAP (OR = 2, 95% CI: 1.3\u20133.1;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.003) increased the odds of a late DNR.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>There was a higher frequency of late DNR orders in our study compared to those reported in several studies worldwide. Cases with potential for a favorable outcome were more likely to have a late DNR order, while those with expected poorer outcomes were more likely to have an early DNR order. The discrepancies highlight the need for clearer guidelines to achieve consistency.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/sjmms.sjmms_141_22","type":"journal-article","created":{"date-parts":[[2022,8,22]],"date-time":"2022-08-22T11:21:30Z","timestamp":1661167290000},"page":"192-197","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":10,"title":["Early Versus Late DNR Orders and its Predictors in a Saudi Arabian ICU: A Descriptive Study"],"prefix":"10.4103","volume":"10","author":[{"given":"Waleed Tharwat","family":"Aletreby","sequence":"first","affiliation":[{"name":"Department of Critical Care, King Saud Medical City, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed F.","family":"Mady","sequence":"additional","affiliation":[{"name":"Department of Critical Care, King Saud Medical City, Riyadh, Saudi Arabia"},{"name":"Department of Anesthesia, Faculty of Medicine, Tanta University, Tanta, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed A.","family":"Al-Odat","sequence":"additional","affiliation":[{"name":"Department of Critical Care, King Saud Medical City, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed N.","family":"Balshi","sequence":"additional","affiliation":[{"name":"Department of Critical Care, King Saud Medical City, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anas A.","family":"Mady","sequence":"additional","affiliation":[{"name":"Department of College of Medicine, Al-Faisal University, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam M.","family":"Al-Odat","sequence":"additional","affiliation":[{"name":"College of Medicine, Jordanian University of Science and Technology, Amman, Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amira M.","family":"Elshayeb","sequence":"additional","affiliation":[{"name":"Department of Critical Care, King Saud Medical City, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed F.","family":"Mostafa","sequence":"additional","affiliation":[{"name":"Department of Critical Care, King Saud Medical City, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shereen A.","family":"Abd Elsalam","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, King Salman Hospital, Riyadh, Saudi Arabia"},{"name":"Department of Internal Medicine and Hematology, Faculty of Medicine, Tanta University, Tanta, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kriz L.","family":"Odchigue","sequence":"additional","affiliation":[{"name":"Department of Nursing, King Saud Medical City, Riyadh, Saudi 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