Formiga F, Chivite D, Ortega C, Casas S, Ramón J M, Pujol R
Geriatric Unit - Internal Medicine Service, Hospital Universitari de Bellvitge 'Princeps d'Espanya', L'Hospitalet de Llobregat 08907, Barcelona, Spain.
QJM. 2004 Dec;97(12):803-8. doi: 10.1093/qjmed/hch135.
Heart failure is increasing in prevalence and incidence, with considerable mortality among the elderly.
To determine preferences concerning cardiopulmonary-resuscitation (CPR) and end-of-life care in elderly patients hospitalized for heart failure.
Prospective interview-based survey.
Patients >64 years old admitted for acute heart failure were interviewed to address their preferences regarding end-of-life care and cardio-pulmonary resuscitation (CPR) when facing the last stages of their disease.
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.
Advance planning of end-of-life procedures and doctor-patient communication regarding these items remains poor and must be improved.
心力衰竭的患病率和发病率正在上升，老年人的死亡率相当高。
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。
基于前瞻性访谈的调查。
对因急性心力衰竭入院的64岁以上患者进行访谈，以了解他们在疾病末期对临终关怀和心肺复苏（CPR）的偏好。
我们采访了80名患者（平均年龄79岁；58%为女性）。32名（40%）表示不希望进行心肺复苏。只有两人之前与医生讨论过他们对心肺复苏的偏好。当认为不太可能从疾病中康复时，40名（50%）参与者希望在家中接受治疗，32名（40%）希望在医院接受管理，8名（10%）不确定。33名患者（41%）表示希望获得精神支持，38名（48%）表示不希望，其余9名（11%）无动于衷。
临终程序的预先规划以及关于这些事项的医患沟通仍然很差，必须加以改善。
