Supplemental Table 1. ICD-9 Code Listing for Diagnoses and Procedures
Diagnosis ICD-9-CM Codes
Septic Shock 785.52
Acute Respiratory Failure 518.81, 518.82, 518.84, 799.1
Acute Renal Failure 584
Acute Neurological Failure 294, 348.1, 348.3
Acute Hematologic Failure 286.6, 286.9, 287.4, 287.5
Acute Liver Failure 570, 573.4
Acidemia 276.2
Pneumonia 481, 482, 483, 484, 485, 486, 487
Bacteremia or Fungemia 038, 790.7, 112.5, 117.9 Abdominal Infection 540, 541, 557, 562.1, 567, 569.83, 574, 575 Soft Tissue Infection 680, 681, 682, 683, 684. 686, 35
Genitourinary Infection 590, 599
Dementia 290, 294, 331
Procedure codes
Activated Protein C 00.11
Mechanical Ventilation 96.7
Atrial Cardioversion 99.61
Cardiopulmonary Resuscitation 99.60, 99.62, 99.63
Hemodialysis 39.95
Right Heart Catheterization 89.63, 89.64, 89.66, 89.67, 89.68
Vasopressor 00.17
Arterial Catheterization 38.91
Central Venous Catheterization 38.93
Supplemental Digital Content - Table 2. Demographics, Comorbidities Present On Admission and Acute Organ Failure Present On Admission in Patients Without and With an Early DNR Order
N(%) unless otherwise specified
No Early DNR N = 19609
Early DNR
N = 4799 p Value
Demographics
Age (mean ± sd) 67 ± 16 75 ± 14 < 0.001
Race/Ethnicity < 0.001
White 10477 (53) 2961 (62)
Black 1737 (9) 288 (6)
Hispanic 4275 (22) 899 (19)
Other 3120 (16) 651 (14)
Sex, Female 9319 (48) 2476 (52) < 0.001
Homeless 71 (0.4) 10 (0.2) 0.1
Primary Payer < 0.001
Medicare 11921 (61) 3644 (75.9)
Medicaid 3320 (16.9) 477 (9.9)
Private Insurance 3369 (17.2) 554 (11.5)
Self-Pay 566 (2.9) 79 (1.6)
Location 0.129
Urban 18314 (96) 4458 (95)
Small Town 587 (3) 148 (3)
Rural 254 (1) 80 (2)
Admission Source < 0.001
Emergency Dept. 16464 (84) 4204 (88)
Another Hospital 1222 (6.2) 234 (4.9)
Other Health Facility Including LTC 611 (3.1) 124 (2.6) Court/Law Enforcement or Other 1311 (6.7) 2 (4.9)
Comorbidities
Number of comorbidities (mean ± sd) 4.5 ± 2.0 4.4 ± 2.0 0.29
Congestive Heart Failure 5981 (30.5) 1571 (32.7) 0.003
Valvular Disease 1514 (7.7) 427 (8.9) 0.007
Pulmonary Circulation Disease 827 (4.2) 194 (4.0) 0.59
Peripheral Vascular Disease 1954 (10.0) 552 (11.5) 0.002
Hypertension w/ and w/o Complications 10516 (53.6) 2631 (54.8) 0.14
Paralysis 1646 (8.4) 433 (9.0) 0.16
Other Neurological Disorders 3223 (16.4) 954 (19.9) < 0.001
Chronic Pulmonary Disease 5325 (27.2) 1279 (26.7) 0.48
Diabetes w/o Chronic Complications 5321 (27.1) 1216 (25.3) 0.012 Diabetes w/ Chronic Complications 2072 (10.6) 426 (8.9) 0.001
Hypothyroidism 2423 (12.4) 695 (14.5) < 0.001
Renal failure 5842 (29.8) 1473 (30.7) 0.22
Liver disease 1736 (8.6) 375 (7.8) 0.022
Peptic ulcer Disease w/ Bleeding 15 (0.1) 5 (0.1) 0.55
Acquired Immune Deficiency Syndrome 48 (0.2) 8 (0.2) 0.31
Lymphoma 448 (2.3) 120 (2.5) 0.37
Metastatic Cancer 1146 (5.8) 423 (8.8) < 0.001
Solid Tumor w/out Metastasis 749 (3.8) 212 (4.4) 0.056
Rheumatoid Arthritis/Collagen Vascular
Disease 685 (3.5) 160 (3.3) 0.59
Coagulopathy 4542 (23.2) 961 (20.0) < 0.001
Obesity 1683 (8.6) 239 (5.0) < 0.001
Weight Loss 3512 (17.9) 850 (17.7) 0.75
Fluid and Electrolyte Disorders 12915 (65.9) 3209 (66.9) 0.19
Chronic Blood Loss Anemia 621 (3.2) 117 (2.4) 0.008
Deficiency Anemias 8165 (41.6) 1811 (37.7) < 0.001
Alcohol Abuse 1293 (6.6) 235 (4.9) < 0.001
Drug Abuse 841 (4.3) 87 (1.8) < 0.001
Psychoses 1101 (5.6) 182 (3.8) < 0.001
Depression 1481 (7.6) 433 (9.0) 0.001
Dementia 1695 (8.6) 919 (19.1) < 0.001
Acute Organ Failures
Number of Acute Organ Failures
(mean ± sd) 1.38 ± 1.15 1.44 ± 1.15 0.002
Respiratory Failure 8879 (45.3) 2167 (45.2) 0.88
Renal Failure 8167 (41.7) 2229 (46.5) < 0.001
Neurological Failure 1886 (9.6) 460 (9.6) 0.95
Hematologic Failure 3554 (18.1) 805 (16.8) 0.029
Liver Failure 948 (4.8) 244 (5.1) 0.47
Acidemia 3565 (18.2) 984 (20.5) < 0.001
Pneumonia 7994 (40.8) 1825 (38.0) < 0.005
Bacteremia or Fungemia 4664 (23.8) 1266 (26.4) < 0.001
Abdominal Infection 3037 (15.5) 670 (14.0) 0.008
Soft Tissue Infection 1586 (8.1) 260 (5.4) < 0.001
Genitourinary Infection 7340 (37.4) 1874 (39.1) 0.04
Supplemental Digital Context - Figure 1.Calibration Plot for multivariate regression models of hospital mortality with and without including early DNR status
