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The influence of the probability of survival on patients' preferences regarding cardiopulmonary resuscitation.

Abstract

BACKGROUND

Studies suggest that a majority of elderly patients would want to undergo cardiopulmonary resuscitation (CPR) if they had a cardiac arrest. Yet few studies have examined their preferences after clinicians have informed them about the outcomes of CPR.

METHODS

To study older patients' preferences regarding CPR, we interviewed as many ambulatory patients as possible in one geriatrics practice in Denver from August 1, 1991, through July 31, 1992.

RESULTS

A total of 371 patients at least 60 years of age were eligible; 287 completed the interview (mean age, 77 years; range, 60 to 99). When asked about their wishes if they had cardiac arrest during an acute illness, 41 percent opted for CPR before learning the probability of survival to discharge. After learning the probability of survival (10 to 17 percent), 22 percent opted for CPR. Only 6 percent of patients 86 years of age or older opted for CPR under these conditions. When asked about a chronic illness in which the life expectancy was less than one year, 11 percent of the 287 patients opted for CPR before learning the probability of survival to discharge. After learning the probability of survival (0 to 5 percent), 5 percent said they would want CPR.

CONCLUSIONS

Older patients readily understand prognostic information, which influences their preferences with respect to CPR. Most do not want to undergo CPR once a clinician explains the probability of survival after the procedure.

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  • Authors+Show Affiliations

    ,

    Senior Citizen's Health Center, Presbyterian-St. Luke's Medical Center, Denver, CO 80218.

    , , , , ,

    Source

    The New England journal of medicine 330:8 1994 Feb 24 pg 545-9

    MeSH

    Advance Directives
    Aged
    Aged, 80 and over
    Cardiopulmonary Resuscitation
    District of Columbia
    Female
    Health Knowledge, Attitudes, Practice
    Heart Arrest
    Humans
    Male
    Patient Education as Topic
    Patient Satisfaction
    Probability
    Prognosis
    Survival Analysis

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    8302322

    Citation

    Murphy, D J., et al. "The Influence of the Probability of Survival On Patients' Preferences Regarding Cardiopulmonary Resuscitation." The New England Journal of Medicine, vol. 330, no. 8, 1994, pp. 545-9.
    Murphy DJ, Burrows D, Santilli S, et al. The influence of the probability of survival on patients' preferences regarding cardiopulmonary resuscitation. N Engl J Med. 1994;330(8):545-9.
    Murphy, D. J., Burrows, D., Santilli, S., Kemp, A. W., Tenner, S., Kreling, B., & Teno, J. (1994). The influence of the probability of survival on patients' preferences regarding cardiopulmonary resuscitation. The New England Journal of Medicine, 330(8), pp. 545-9.
    Murphy DJ, et al. The Influence of the Probability of Survival On Patients' Preferences Regarding Cardiopulmonary Resuscitation. N Engl J Med. 1994 Feb 24;330(8):545-9. PubMed PMID: 8302322.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - The influence of the probability of survival on patients' preferences regarding cardiopulmonary resuscitation. AU - Murphy,D J, AU - Burrows,D, AU - Santilli,S, AU - Kemp,A W, AU - Tenner,S, AU - Kreling,B, AU - Teno,J, PY - 1994/2/24/pubmed PY - 1994/2/24/medline PY - 1994/2/24/entrez SP - 545 EP - 9 JF - The New England journal of medicine JO - N. Engl. J. Med. VL - 330 IS - 8 N2 - BACKGROUND: Studies suggest that a majority of elderly patients would want to undergo cardiopulmonary resuscitation (CPR) if they had a cardiac arrest. Yet few studies have examined their preferences after clinicians have informed them about the outcomes of CPR. METHODS: To study older patients' preferences regarding CPR, we interviewed as many ambulatory patients as possible in one geriatrics practice in Denver from August 1, 1991, through July 31, 1992. RESULTS: A total of 371 patients at least 60 years of age were eligible; 287 completed the interview (mean age, 77 years; range, 60 to 99). When asked about their wishes if they had cardiac arrest during an acute illness, 41 percent opted for CPR before learning the probability of survival to discharge. After learning the probability of survival (10 to 17 percent), 22 percent opted for CPR. Only 6 percent of patients 86 years of age or older opted for CPR under these conditions. When asked about a chronic illness in which the life expectancy was less than one year, 11 percent of the 287 patients opted for CPR before learning the probability of survival to discharge. After learning the probability of survival (0 to 5 percent), 5 percent said they would want CPR. CONCLUSIONS: Older patients readily understand prognostic information, which influences their preferences with respect to CPR. Most do not want to undergo CPR once a clinician explains the probability of survival after the procedure. SN - 0028-4793 UR - https://www.unboundmedicine.com/medline/citation/8302322/The_influence_of_the_probability_of_survival_on_patients'_preferences_regarding_cardiopulmonary_resuscitation_ L2 - http://www.nejm.org/doi/full/10.1056/NEJM199402243300807?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -