RESUSCITATION DECISION-MAKING IN THE ELDERLY - THE VALUE OF OUTCOME DATA

Objective: To assess the relationship between cardiopulmonary resuscit ation (CPR) information and desire for CPR in an elderly population an d to determine the influence of outcome data on desire for CPR in olde r persons. Design: An interventional study utilizing an educational pr ogram. Setting: Elderly independent retirement community. Participants : One hundred two persons, all more than 62 years old, who were neithe r demented nor depressed. Intervention: Participants received an educa tional intervention consisting of descriptive CPR information and quan titative information about CPR outcomes. CPR information, survival est imates, and preferences were recorded prior to and after the intervent ion. 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 fiv e hypothetical clinical scenarios after the intervention (p < 0.05). T hose who were more realistic in their estimates of CPR survival desire d less CPR in the hypothetical scenarios (p < 0.0 1). A trend in our d ata suggests that quantitative outcome information may have a greater influence on CPR preferences than has descriptive information (p = 0.0 7). Conclusions: CPR preferences changed after an educational interven tion. An improved understanding of quantitative outcome data appears t o influence the desire for CPR and therefore should be included in CPR discussions with older patients.