End-of-life preferences in elderly patients admitted for heart failure
End-of-life preferences in elderly patients admitted for heart failure
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DOI：
10.1093/qjmed/hch135
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发表时间：
2004-12-01
影响因子：
13.3
通讯作者：
Pujol, R
中科院分区：
文献类型：
--
作者：
Formiga, F;Chivite, D;Pujol, R
背景资料：心力衰竭的患病率和发病率正在增加，老年人的死亡率相当高。目的：确定因心力衰竭住院的老年患者对心肺复苏（CPR）和临终关怀的偏好。设计：前瞻性访谈调查。方法：对因急性心力衰竭入院的>64岁患者进行访谈，以了解他们对临终关怀和心肺复苏的偏好（结果：我们采访了80名患者（平均年龄79岁，58%为女性）。32人（40%）表示不希望进行CPR。只有两个人之前与他们的医生讨论了他们的心肺复苏术偏好。当从疾病中恢复被认为是不可能的，40（50%）的参与者更喜欢在家里接受治疗，32（40%）的首选在医院管理，8（10%）是不确定的。33例患者（41%）表示希望精神上的支持，38（48%）说，没有和其余9（11%）是intellectual.Discussion：提前规划的结束生命的程序和医患沟通有关这些项目仍然很差，必须加以改善。
Background: Heart failure is increasing in prevalence and incidence, with considerable mortality among the elderly.Aim: To determine preferences concerning cardiopulmonary-resuscitation (CPR) and end-of-life care in elderly patients hospitalized for heart failure.Design: Prospective interview-based survey.Methods: Patients >64 years old admitted for acute heart failure were interviewed to address their preferences regarding end-of-life care and cardiopulmonary resuscitation (CPR) when facing the last stages of their disease.Results: We interviewed 80 patients (mean age 79 years; 58% women). Thirty-two (40%) expressed a wish not to have CPR. Only two had previously discussed their CPR preferences with their physicians. When recovery from the illness was considered unlikely, 40 (50%) participants preferred to receive treatment at home, 32 (40%) preferred in-hospital management, and 8 (10%) were unsure. Thirty-three patients (41%) expressed a desire for spiritual support, 38 (48%) said not and the remaining 9 (11%) were indifferent.Discussion: Advance planning of end-of-life procedures and doctor-patient communication regarding these items remains poor and must be improved.