Original Article The Relation Between the Timing of Palliative Care and the Frequency and Timing of Do-Not-Resuscitate Orders Among Cancer Deaths in a Tertiary Care

The medical records of 246 in-hospital cancer deaths were reviewed to explore the relation between palliative care (PC) timing and the frequency and timing of do-not-resuscitate (DNR) designation. The rate of DNR designation was 100 % in patients referred to PC and 82 % in those never referred (P <.001). Patients were grouped into 4 groups: early PC (>90 days from PC referral to death), intermediate PC (>30-90 days), late PC (30 days), and no PC. The median DNR to death time was 96, 41, 11, and 3 days, respectively (P <.001). The proportion of intensive care unit (ICU) deaths was 0%, 1%, 3%, and 27%, respec-tively (P <.001). In conclusion, in a tertiary care hospital, earlier PC was associated with earlier DNR designation and less frequent ICU deaths among in-hospital cancer deaths