American Society of Anesthesiologists guidelines recommend that anesthesiologists revisit do-not-resuscitate orders preoperatively and revise them if necessary based on patient preferences. In patients without do-not-resuscitate orders or other directives limiting treatment however, "full code" is the default option irrespective of clinical circumstances and patient preferences. It is time to revisit this approach based on (1) increasing understanding of the power of default options in healthcare settings, (2) changing demographics and growing evidence suggesting that an expanding subset of patients is vulnerable to poor outcomes after perioperative cardiopulmonary resuscitation (CPR), and (3) recommendations from multiple societies promoting risk assessment and goal-concordant care in older surgical patients. The authors reconsider current guidelines in the context of these developments and advocate for an expanded approach to decision-making regarding CPR, which involves identifying high-risk elderly patients and eliciting their preferences regarding CPR irrespective of existing or presumed code status.

中文翻译：

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超越不复苏令：老年外科患者心肺复苏决策的扩展方法。

美国麻醉医师协会指南建议麻醉医师在术前重新审视不复苏命令，并在必要时根据患者的偏好进行修改。然而，对于没有禁止复苏命令或其他限制治疗指令的患者，无论临床情况和患者偏好如何，“完整代码”都是默认选项。是时候重新审视这种方法了，基于 (1) 增加对医疗环境中默认选项的力量的理解，(2) 不断变化的人口统计数据和越来越多的证据表明越来越多的患者在围手术期心肺复苏 (CPR) 后容易出现不良结果)，以及 (3) 来自多个促进老年手术患者风险评估和目标一致护理的协会的建议。