Many hospitalized patients overestimate their chance of surviving an in-hospital cardiac arrest and do not know what CPR really involves, a University of Iowa study has shown.
The study further showed that this lack of understanding of cardiopulmonary resuscitation may affect a patient's choice about whether to have orders in place to be resuscitated if they are dying.
The study, which also involved researchers in the Iowa City Veterans Affairs Medical Center, appeared in the June 1 issue of the Journal of Medical Ethics.
"The investigation indicates that doctors need to do more to help patients understand CPR procedures and 'do not resuscitate', or DNR, orders to avoid gaps between treatments used and patients' actual preferences," said the study's lead author Lauris Kaldjian, M.D., Ph.D., associate professor of internal medicine at the UI Roy J. and Lucille A. Carver College of Medicine and a physician with UI Hospital and Clinics.
"Our study showed that after people were asked about their goals of care and then informed about the chances of survival and good brain function after CPR, nearly one in five said their preferences about CPR had changed," added Kaldjian, who also directs the college's Program in Bioethics and Humanities.
The study involved 135 adults who were interviewed within 48 hours of being admitted to the hospital for general medical treatment from June to August 2007. Many other studies on resuscitation preferences have been based in outpatient settings or on hypothetical scenarios. In contrast, this study interviewed patients while they were being treated in the hospital, Kaldjian noted.
The patients' average age was 48 and just over half were women. Ethnicity was 92 percent white, 4 percent black, 3 percent Hispanic and 1 percent Asian. Very few patients had cancer or heart disease, but 61 percent of them had received intensive care in the past, indicating that they had al
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University of Iowa