Quality of life after in-hospital cardiopulmonary resuscitation for patients over the age of 80 years

被引:7
作者
Burden, Eleanor [1 ]
Pollock, Lucy [1 ]
Paget, Camilla [1 ]
机构
[1] Musgrove Pk Hosp, Taunton TA15DA, Somerset, England
关键词
CARDIAC-ARREST; SURVIVAL;
D O I
10.1136/postgradmedj-2019-136565
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objectives Success of in-hospital resuscitation decreases with age; however, national data show that 11.3% of patients over 80 years survive to discharge. There are few published qualitative data about the quality of life for these patients postsuccessful resuscitation. We aimed to investigate postresuscitation quality of life in patients over the age of 80 through a series of case studies. Methods All patients over the age of 80 years, who received cardiopulmonary resuscitation (CPR) at our district general hospital in 2015-2016, were included. Success of resuscitation, survival at day 1 and to discharge were recorded. For patients who survived to 1 day and beyond, case reports were written to create individual patient stories. Results 47 patients over the age of 80 years received CPR at Musgrove Park Hospital over a 2-year period. Five (10.6%) survived to discharge. Of those surviving to discharge, two had substantial functional decline, requiring discharge to nursing homes having previously been independent. Of the five families/patients who commented on their experience, only one expressed a positive view. When discussed, the majority of patients/families opted for a Do Not Attempt CPR. Conclusion Our results have shown that there is a risk of substantial functional decline associated with successful CPR in those patients over the age of 80 years. The majority of patients and relatives contacted after successful resuscitation expressed a negative view of the experience. Our study highlights the importance of having early informed discussions with patients and families about CPR in order to avoid detrimental outcomes and ensure patient wishes are correctly represented.
引用
收藏
页码:186 / 189
页数:4
相关论文
共 12 条
[1]  
[Anonymous], 2017, BMJ BRIT MED J, DOI DOI 10.1136/BMJ.J813
[2]  
Findlay G., 2012, Time to intervene? A review of patients who underwent cardiopulmonary resuscitation as a result of an in-hospital cardiorespiratory arrest
[3]   The Universal Form of Treatment Options (UFTO) as an Alternative to Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) Orders: A Mixed Methods Evaluation of the Effects on Clinical Practice and Patient Care [J].
Fritz, Zoe ;
Malyon, Alexandra ;
Frankau, Jude M. ;
Parker, Richard A. ;
Cohn, Simon ;
Laroche, Clare M. ;
Palmer, Chris R. ;
Fuld, Jonathan P. .
PLOS ONE, 2013, 8 (09)
[4]   Advance care planning [J].
Gillick, MR .
NEW ENGLAND JOURNAL OF MEDICINE, 2004, 350 (01) :7-8
[5]  
Mawer C, 2019, AMA J ETHICS, V21, P373
[6]   FUTILE TREATMENTS AND DYING PATIENTS Cardiopulmonary resuscitation can be futile and sometimes worse in dying patients [J].
Mawer, Caroline .
BMJ-BRITISH MEDICAL JOURNAL, 2014, 349
[7]   THE INFLUENCE OF THE PROBABILITY OF SURVIVAL ON PATIENTS PREFERENCES REGARDING CARDIOPULMONARY-RESUSCITATION [J].
MURPHY, DJ ;
BURROWS, D ;
SANTILLI, S ;
KEMP, AW ;
TENNER, S ;
KRELING, B ;
TENO, J .
NEW ENGLAND JOURNAL OF MEDICINE, 1994, 330 (08) :545-549
[8]   Incidence and outcome of in-hospital cardiac arrest in the United Kingdom National Cardiac Arrest Audit [J].
Nolan, Jerry P. ;
Soar, Jasmeet ;
Smith, Gary B. ;
Gwinnutt, Carl ;
Parrott, Francesca ;
Power, Sarah ;
Harrison, David A. ;
Nixon, Edel ;
Rowan, Kathryn .
RESUSCITATION, 2014, 85 (08) :987-992
[9]   A patient and relative centred evaluation of treatment escalation plans: a replacement for the do-not-resuscitate process [J].
Obolensky, L. ;
Clark, T. ;
Matthew, G. ;
Mercer, M. .
JOURNAL OF MEDICAL ETHICS, 2010, 36 (09) :518-520
[10]  
Perkins G D., 2016, Do-not-attempt-cardiopulmonary-resuscitation decisions: an evidence synthesis, DOI [DOI 10.3310/HSDR04110, 10.3310/hsdr04110]