Incidence of Unconfirmed Code Status Documentation in Surgical Patients with Preoperative Medical Orders for Life Sustaining Treatment (MOLST)
Authors' conclusion
Use of unconfirmed code status orders was nearly universal in this surgical population, indicating that even patients with preexisting documented preferences are at risk of code status ambiguity in the EHR.
Study context
- Population
- Surgical patients with preexisting MOLST forms undergoing OR procedures at a tertiary care center over one year
- Participants
- 402 patients
- Outcome
- Prevalence of unconfirmed code statuses
Methodological detailschart review, single-centre
- Chart review
- Single-centre
Main finding
As reported in the abstract
At least one unconfirmed code status during encounter
Patients with at least one unconfirmed code status
92.5%
Observational data: associations, not effects.
Further findings
Total time with an unconfirmed order
- Median total time with unconfirmed order (IQR 9.0-122.6)
- 48.7 hours
Discharged with an unconfirmed code status (admitted patients)
- Admitted patients discharged with unconfirmed code status
- 52.6%
MOLST indicating no CPR and/or no intubation among patients with unconfirmed code statuses
- Unconfirmed code status patients with MOLST indicating no CPR and/or no intubation
- 54.3%
Timing of risk
- Most at risk of an unconfirmed code status during admission and on the day of surgery
Death with "full code presumed" order in place
- Patients who died with "full code presumed" in place
- 2
Original publication
Incidence of Unconfirmed Code Status Documentation in Surgical Patients with Preoperative Medical Orders for Life Sustaining Treatment (MOLST). Ann Surg. Published 22 December 2025. doi:10.
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