Importantly, a recent study showed that in elderly
patients with CAP, the decision to use a do not
resuscitate (DNR) order was taken in nearly 30%
of hospitalized patients [Oshitani et al. 2013]. In
this study physicians were more inclined to propose
DNR orders when CAP patients demonstrated
older in age (more than 75 years), poor
performance status, dementia, aspiration, low
albumin, extensive consolidation, and respiratory
failure. The decision to use DNR orders did not
make physicians choose less-intense antimicrobial
treatments. Nevertheless effort to detect bacteria
was not made in the DNR group as
elaborately as in the non-DNR group.
They also found that the DNR group has
higher 30-day mortality.