Background: In Norway, few studies have been done to map the extent of do-not-resuscitate (DNR) orders and the consequence for patients (treatment and outcome).
Material and methods: All patients with DNR orders, referred to the stroke unit of Akershus University Hospital during the year 2005, were identified and data on treatment and outcome were recorded.
Results: A DNR order was found for 79 of 855 (9 %) patients (mean age 80 years [SD 9]). Reasons for referral to hospital were: cerebral infarction (49 [62 %] patients), intracerebral haemorrhage (28 [35 %] patients), and other diseases (2 [3 %] patients). Mean NIH Stroke Scale was 19 (SD 6) (scale 0 - 42; 0 in score meaning no stroke related symptoms). Hospital mortality was 39/79 (49 %). Apart from once, all decisions regarding withholding and/or withdrawing life-sustaining treatment were taken in the aftermath of a DNR order. For 43 patients (54 %), treatment was limited in some way and hospital mortality for this group was 27/43 (63 %). Mortality was 12/36 (33 %) for those who had full treatment. 45 patients (57 %) with a DNR order had a bacterial infection and 32 of them were treated with antibiotics (71 %).
Interpretation: Patients with DNR orders were old and had had severe stroke. Treatment was rarely withheld despite high morbidity and mortality among the patients.