Do-not-intubate status and COVID-19 mortality in patients admitted to Dutch non-ICU wards

van der Veer, Tjeerd; van der Sar-van der Brugge, Simone; Paats, Marthe S.; van Nood, Els; de Backer, Ingrid C.; Aerts, Joachim G. J. V.; van der Eerden, Menno M.

Mortality from COVID-19 has been particularly high in elderly patients on mechanical ventilation. Treatment outcomes for patients with do-not-intubate (DNI) status are unknown. One hundred patients admitted to the non-ICU ward during the “first wave” were retrospectively analyzed. Mortality rate was 49% in patients with a DNI order. This subgroup was characterized by significantly higher age, more comorbidity, and care dependency. Mortality among DNI patients was three times higher than other patients, but not higher than some of the published mortality rates for elderly mechanically ventilated patients. Advanced care planning is essential in COVID-19 to assist patient autonomy and prevent non-beneficial medical interventions.