International Journal of Gerontology
Volume 3, Issue 1 , Pages 16-25, March 2009

Factors Analysis of Cardiopulmonary Resuscitation Outcomes in the Elderly in Taiwan

  • Wen-Han Chang

      Affiliations

    • Emergency Department, Mackay Memorial Hospital, Taipei, Taiwan
    • National Taipei University of Technology, Taipei, Taiwan
    • Mackay Medicine, Nursing and Management College, Taipei, Taiwan
    • Graduate Institute of Injury Prevention and Control, Taipei Medical University, Taipei, Taiwan
    • Corresponding Author InformationCorrespondence to: Dr Wen-Han Chang, Emergency Department, Mackay Memorial Hospital, 92, Section 2, Chung-Shan North Road, Taipei, Taiwan
    • ,
  • Chien-Hsuan Huang

      Affiliations

    • Department of Rehabilitation, Tai-En Memorial Hospital, Taipei, Taiwan
    • ,
  • Ding-Kuo Chien

      Affiliations

    • Emergency Department, Mackay Memorial Hospital, Taipei, Taiwan
    • Mackay Medicine, Nursing and Management College, Taipei, Taiwan
    • ,
  • Yu-Jang Su

      Affiliations

    • Emergency Department, Mackay Memorial Hospital, Taipei, Taiwan
    • Mackay Medicine, Nursing and Management College, Taipei, Taiwan
    • ,
  • Po-Chen Lin

      Affiliations

    • Emergency Department, Mackay Memorial Hospital, Taipei, Taiwan
    • ,
  • Cheng-Ho Tsai

      Affiliations

    • Section of Cardiology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan

Accepted 28 February 2009.

Article Outline

SUMMARY 

Performing cardiopulmonary resuscitation (CPR) can save countless lives, but its use is rather controversial in elderly patients. Some researchers believe that there is an inverse ratio between the success of CPR and the age of the patient, while others believe that the uniqueness of each case and existing comorbidities are more important factors. CPR can result in severe injury for patients. Therefore, physicians often face a dilemma between rational and moral decisions when dealing with older patients suffering from cardiac arrest. The solution to this problem rests on the determination of whether CPR will benefit the patient. This analysis, supported by a literature review and a review of the outcomes of CPR, considered different factors in elderly patients, including age, sex, prehospital emergency medical service, preexisting disease, witnessed cardiac arrest, initial arrest electrocardiogram rhythm, CPR locations, and ethics. Quality of life and the cost of medical care for the elderly affect the benefit analysis of CPR. Indeed, a large amount of money is spent on elderly CPR patients who remain in critical condition before finally dying in the hospital. Factors contributing to decisions to resuscitate also include post-resuscitation quality of life, and the will of patients, families and doctors. In short, patient age is not a barrier to performing CPR. However, to achieve the best outcome of CPR, one must consider the disease diagnosis of elderly patients as a useful reference to help improve medical care for this group.

Key Words:  cardiopulmonary resuscitation , elderly patients , ethics , medical futility , survival to discharge

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PII: S1873-9598(09)70016-X

doi:10.1016/S1873-9598(09)70016-X

International Journal of Gerontology
Volume 3, Issue 1 , Pages 16-25, March 2009

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