Do-not-resuscitate status and regional analgesia utilization for fracture pain: a comfort paradox?
Authors' conclusion
Do-not-resuscitate status is associated with lower regional analgesia utilization for rib fractures but not hip fractures.
Study context
- Population
- Adult (≥18 years) hospitalizations for rib and hip fractures, National Inpatient Sample, January 1, 2016, through December 31, 2022298,343 rib and 462,796 hip fracture hospitalizations
- Exposure
- DNR status vs no DNR status
- Outcome
- Receipt of regional analgesia
Methodological detailsNational Inpatient Sample, adjusted analyses, frailty-stratified analyses
- National Inpatient Sample
- Adjusted analyses
- Frailty-stratified analyses
Main finding
As reported in the abstract
Receipt of RA by DNR status
DNR vs No DNROdds ratio (95% CI)
Rib fractures
0.76(0.69–0.83)
Hip fractures
1.00(0.94–1.06)
Observational data: associations, not effects.
Further findings
| Outcome | OR (95% CI) | |
|---|---|---|
| Receipt of RA, least frail rib fracture hospitalizations (subgroup)DNR vs No DNR · strongest association · frailty-stratified analyses | 0.34 (0.25–0.48) | |
| 0.20.5125Odds ratio (log scale) |
Overall RA utilization and DNR prevalence
- Rib fracture hospitalizations receiving RA
- 8,568 (2.9%)
- Hip fracture hospitalizations receiving RA
- 13,730 (3.0%)
- DNR status, rib fracture hospitalizations
- 31,882 (10.7%)
- DNR status, hip fracture hospitalizations
- 77,255 (16.7%)
Original publication
Do-not-resuscitate status and regional analgesia utilization for fracture pain: a comfort paradox? Reg Anesth Pain Med. Published 4 September 2026. doi:10.
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