Observational studyBMJ open2025
Do-not-resuscitate status in patients with shock in the emergency department in a tertiary hospital in China: a retrospective observational study.
Observational study in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
- A Walker and Avant concept analysis of slow code practice in end-of-life resuscitation.BMC palliative care · 2026Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesThe study aims to define the prevalence of Do-Not-Resuscitate (DNR) orders among patients with shock in the emergency department (ED) and explore their impact on clinical management and mortality outcomes.
designA retrospective observational cohort study was conducted involving patients presenting to the ED with shock.
settingAn ED in a tertiary hospital in western China.
participants2001 patients (aged ≥18 years) presenting to the ED with shock from 1 January 2022 to 31 December 2023.
methodsThe enrolled patients were divided into DNR (order issued within 24 hours of ED admission)/non-DNR groups. Demographics, vitals, comorbidities, laboratory values, medications and prognoses were obtained from electronic healthcare records. DNR prevalence and its associations with mortality, ICU admission, vasopressor administration and antibiotic administration were assessed via logistic regression.
resultsCompared with patients without DNR orders, patients with DNR orders (n=399 (19.9%)) were older (p<0.001) and more likely to have comorbidities. DNR status was associated with higher in-hospital (17.8% vs 6.5%, p<0.001) and 30-day (32% vs 12%, p<0.001) mortality. However, there were no significant differences in intensive care unit (ICU) admission (64.2% vs 58.8%, p=0.148), ICU length of stay (41.0 hours vs 45.4 hours, p=0.834) or vasopressor use (29.8% vs 25.5%, p=0.082). Logistic regression analysis revealed that ICU admission was associated with the number of antibiotics (p=0.010), vasopressor use (p<0.001) and initial lactate level (p=0.026) but not DNR status (p=0.650). Furthermore, DNR status neither affected vasopressor administration (OR=0.888, 95% CI: 0.671 to 1.174, p=0.405) nor antibiotic administration (OR=1.484, 95% CI: 1.052 to 2.092, p=0.024).
conclusionsCompared with patients with shock in the ED who did not have DNR status, those with DNR status (prevalence ~20%) had higher in-hospital and 30-day mortality (but most survived) and similar ICU admission and intervention treatments.
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