Table 3.
Adjusted Odds Ratios and 95% Confidence Intervals for Dementia and DNR Timing on End-of-Life Hospital Care for 2,566 Persons 65 and Older Who Died in Hospital, 2015–2017.
| Model fit | ||||||
|---|---|---|---|---|---|---|
| AOR | 95% CI | p value | Wald chi square | p value | ||
| Model 1: ICU admission | ||||||
| Dementia diagnosis | 0.60 | 0.49 | 0.73 | <0.001 | 25.38 | <0.001 |
| DNR placement (ref: day of admission) | 79.42 | <0.001 | ||||
| DNR mid-hospitalization | 2.73 | 2.15 | 3.47 | <0.001 | ||
| DNR on day of death | 1.74 | 1.30 | 2.34 | <0.001 | ||
| No DNR | 1.33 | 1.01 | 1.75 | 0.04 | ||
| Model 2: Mechanical ventilation | ||||||
| Dementia diagnosis | 0.82 | 0.67 | 1.00 | 0.05 | 3.93 | 0.05 |
| DNR placement (ref: day of admission) | 92.49 | <0.001 | ||||
| DNR mid-hospitalization | 2.07 | 1.61 | 2.65 | <0.001 | ||
| DNR on day of death | 3.63 | 2.69 | 4.90 | <0.001 | ||
| No DNR | 3.14 | 2.38 | 4.15 | <0.001 | ||
| Model 3: Intubation | ||||||
| Dementia diagnosis | 0.72 | 0.58 | 0.88 | 0.001 | 10.13 | 0.002 |
| DNR placement (ref: day of admission) | 114.94 | <0.001 | ||||
| DNR mid-hospitalization | 2.53 | 1.92 | 3.33 | <0.001 | ||
| DNR on day of death | 4.16 | 3.02 | 5.73 | <0.001 | ||
| No DNR | 4.53 | 3.36 | 6.12 | <0.001 | ||
| Model 4: Resuscitation | ||||||
| Dementia diagnosis | 0.82 | 0.59 | 1.14 | 0.24 | 1.36 | 0.24 |
| DNR placement (ref: day of admission) | 174.69 | <0.001 | ||||
| DNR mid-hospitalization | 1.42 | 0.84 | 2.40 | 0.19 | ||
| DNR on day of death | 2.28 | 1.27 | 4.08 | 0.006 | ||
| No DNR | 10.91 | 6.63 | 17.95 | <0.001 | ||
| Model 5: Feeding tube insertion | ||||||
| Dementia diagnosis | 1.27 | 0.82 | 1.97 | 0.28 | 1.17 | 0.28 |
| DNR placement (ref: day of admission) | 9.29 | 0.03 | ||||
| DNR mid-hospitalization | 2.12 | 1.04 | 4.31 | 0.04 | ||
| DNR on day of death | 1.62 | 0.67 | 3.94 | 0.29 | ||
| No DNR | 3.05 | 1.44 | 6.47 | 0.004 | ||
| Model 6: Any intensive care | ||||||
| Dementia diagnosis | 0.77 | 0.64 | 0.94 | 0.009 | 6.91 | 0.01 |
| DNR placement (ref: day of admission) | 93.89 | <0.001 | ||||
| DNR mid-hospitalization | 2.21 | 1.75 | 2.79 | <0.001 | ||
| DNR on day of death | 2.74 | 2.04 | 3.69 | <0.001 | ||
| No DNR | 3.52 | 2.67 | 4.64 | <0.001 | ||
Notes: ICU = intensive care unit. DNR = do-not-resuscitate order. AOR = adjusted odds ratio. CI = confidence interval. Wald chi square tests compare the improvement in model fit when dementia or timing of DNR placement are included in the model. Bolded values indicate p < 0.05. All models adjust for patient race/ethnicity, insurance status, sex, age at death, hospital of care, length of stay, Charlson Comorbidity Index, and year of death.