Original Articles

Journal of General Internal Medicine

, Volume 8, Issue 6, pp 295-300

Resuscitation decision making in the elderly

The value of outcome data
  • Ronald S. SchonwetterAffiliated withDepartment of Internal Medicine, Division of Geriatric Medicine, University of South Florida College of Medicine
  • , Robert M. Walker
  • , David R. Kramer
  • , Bruce E. Robinson

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Abstract

Objective: To assess the relationship between cardiopulmonary resuscitation (CPR) information and desire for CPR in an elderly population and to determine the influence of outcome data on desire for CPR in older persons.

Design: An interventional study utilizing an educational program.

Setting: Elderly independent retirement community.

Participants: One hundred two persons, all more than 62 years old, who were neither demented nor depressed.

Intervention: Participants received an educational intervention consisting of descriptive CPR information and quantitative information about CPR outcomes. CPR information, survival estimates, and preferences were recorded prior to and after the intervention.

Measurements and main results: Subjects exhibited a high level of basic knowledge about CPR, which did not change with the intervention. While subjects consistently overestimated their chances of survival post CPR, these estimates decreased toward more realistic levels after the intervention (p<0.001). CPR preferences changed in three of five hypothetical clinical scenarios after the intervention (p<0.05). Those who were more realistic in their estimates of CPR survival desired less CPR in the hypothetical scenarios (p<0.01). A trend in our data suggests that quantitative outcome information may have a greater influence on CPR preferences than has descriptive information (p=0.07).

Conclusions: CPR preferences changed after an educational intervention. An improved understanding of quantitative outcome data appears to influence the desire for CPR and therefore should be included in CPR discussions with older patients.

Key words

advance directives medical decision making cardiopulmonary resuscitation CPR outcome data patient preferences elderly