Provider and Patient Gender Influence on Timing of Do-Not-Resuscitate Orders in Hospitalized Patients with Cancer

Abstract Background: End-of-life decisions and advance directives require timely physician–patient discussions but barriers exist to these discussions. Objective: To evaluate the influence of physician and patient gender on the timing of inpatient do-not-resuscitate (DNR) orders. Design: Retrospective cohort study. Setting/Subjects: All adult patients (≥18 years) with cancer who received inpatient DNR orders at The University of Texas MD Anderson Cancer Center between January 2011 and December 2013. Measurements: Gender interaction between physicians and patients towards timing of the DNR order. Results: We identified 4,157 unique patients with a cancer diagnosis. These patients were treated by 353 physicians, of whom 123 (34.8%) were females and 230 (65.2%) were males. Multivariate analysis showed female patients were 1.3 times more likely to have early DNR orders written during hospital admission than were male patients (odds ratio [OR] 1.27; 95% confidence interval [CI] 1.07–1.50). When comparing gende...