Cardiopulmonary Resuscitation Preferences in Dutch Community-dwelling and Hospitalized Elderly People

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Abstract
Objective. To study the effects of information, gender, quality of life, and hospitalization on cardiopulmonary resuscitation (CPR) preferences and on the wish for information and participation in CPR discussions. Methods. Seventy-five community-dwelling inhabitants of the city of Leiden and 45 consecutive patients in two hospitals in Leiden, The Netherlands, aged 75 years or older, were interviewed about their CPR preferences in their current states of health and in three hypothetical scenarios. Health-related quality of life (QOL) was assessed in separate items. The subjects were asked about their wishes for information and participation in CPR discussions. Results. The chances of surviving CPR were overestimated. After receiving accurate information, 65% of the subjects, more women than men, did not want CPR. Overall QOL did not differ between men and women. Concerning the separate QOL items, men's CPR preferences were more associated with pain, whereas women's were more associated with being impaired in physical functioning and daily and social activities. CPR preferences in the current state of health did not differ significantly between community-dwelling and hospitalized participants. Although only 6% of all participants had ever discussed CPR with their doctors, 70% indicated they wanted routine CPR discussions (either when in good health at home or upon hospital admission), and 61 % preferred to make the final decision about CPR themselves. Conclusions. CPR preferences are affected by different QOL items in men and women. CPR preferences in the current state of health do not differ between hospitalized and community-dwelling elderly people. As the majority of elderly people want CPR discussions, they should be involved in decision making concerning CPR. Key words: cardiopulmonary resuscitation preferences; quality of life; elderly; hospitalization. (Med Decis Making 2000;20:423-429)