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Age as a factor in do not attempt cardiopulmonary resuscitation decisions: A multicentre blinded simulation-based study

Moore, Nicholas A; Wiggins, Natasha; Adams, Joe

Palliative medicine. Volume 29:Number 4 (2015); pp 380-385 -- Sage

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  • Title:
    Age as a factor in do not attempt cardiopulmonary resuscitation decisions: A multicentre blinded simulation-based study
  • Author: Moore, Nicholas A;
    Wiggins, Natasha;
    Adams, Joe;
    Bion, Julian;
    Coombs, Maureen
  • Found In: Palliative medicine. Volume 29:Number 4 (2015); pp 380-385
  • Journal Title: Palliative medicine
  • Subjects: Palliative Care--Periodicals; Cancer--Palliative treatment--Periodicals; Pain--Treatment--Periodicals; Palliatieve behandeling; Age groups--cardiopulmonary resuscitation--resuscitation--futility--questionnaires; Dewey: 616.029
  • Rights: legaldeposit
  • Publication Details: Sage
  • Abstract: Background:

    The European Resuscitation Council Guidelines recognise that there is a lack of direct evidence for the effect of age on outcome following cardiopulmonary resuscitation.

    Aim:

    To determine the role that advancing age plays in the decision by clinicians to complete a do not attempt cardiopulmonary resuscitation order based on perceived futility.

    Design:

    A questionnaire-based trial. Clinicians were randomly assigned to receive one of two versions of a patient case, varying in age but otherwise identical (90 years vs 60 years). Participants were asked to decide whether a do not attempt cardiopulmonary resuscitation form should be completed based on perceived futility for a single patient case. Rates of do not attempt cardiopulmonary resuscitation order were compared between groups.

    Participants:

    Consultant physicians, surgeons and anaesthetists from 12 district general hospitals in England.

    Results:

    In total, 291 questionnaires were returned. Overall, clinicians were significantly more likely to complete a do not attempt cardiopulmonary resuscitation form for a 90-year-old patient than a 60-year-old patient, when all other factors are equal (67.7% vs 7.4%, p  < 0.001). This finding was consistent across speciality and experience level of the consultant. Surgeons were found to be significantly less likely to complete a do not attempt cardiopulmonary resuscitation order in the 90-year-old patient compared to other consultants (46.4% vs 74.1%, p  < 0.001). Anaesthetists were more likely than other consultants to complete a do not attempt cardiopulmonary resuscitation order in the 60-year-old patient (17.8% vs 4.3%, p  < 0.05).

    Conclusion:

    Age is a highly significant independent factor in a clinicians' decision to withhold cardiopulmonary resuscitation. We highlight a potential gap between current practice and supporting evidence base.


  • Identifier: System Number: LDEAvdc_100059889077.0x000001; Journal ISSN: 0269-2163; 10.1177/0269216314566838
  • Publication Date: 2015
  • Physical Description: Electronic
  • Shelfmark(s): ELD Digital store

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