A video depicting resuscitation did not impact upon patients' decision-making

Abstract

Caitlin Richardson-Royer,1 Imran Naqvi,1 Christopher Riffel,1 Lawrence Harvey,1 Domonique Smith,1 Dagmawe Ayalew,1 Nasim Motayar,1 Yaw Amoateng-Adjepong,1,2 Constantine A Manthous3 1The Jewish Hospital of Cincinnati, Cincinnati, OH, USA; 2Yale University School of Medicine, New Haven, CT, USA; 3Lawrence & Memorial Hospital, New London, CT, USA Background: Previous studies have demonstrated that video of and scripted information about cardiopulmonary resuscitation (CPR) can be deployed during clinician–patient end-of-life discussions. Few studies, however, examine whether video adds to verbal information-sharing. We hypothesized that video augments script-only decision-making. Methods: Patients aged >65 years admitted to hospital wards were randomized to receive evidence-based information (“script”) vs. script plus video of simulated CPR and intubation. Patients’ decisions registered in the hospital record, by hospital discharge were compared for the two groups. Results: Fifty script-only intervention patients averaging 77.7 years were compared to 50 script+video patients with a mean age of 74.7 years. Eleven of 50 (22%) in each group declined CPR; and an additional three (script) vs. four (script+video) refused intubation for respiratory failure. There were no differences in sex, self-reported health trajectory, functional limitations, length of stay, or mortality associated with decisions. Conclusion: The rate at which verbally informed hospitalized elders opted out of resuscitation was not impacted by adding a video depiction of CPR. Keywords: end of life, cardiopulmonary resuscitation, CPR, intubation, mechanical ventilation, autonomy

Keywords

• End of life
• cardiopulmonary resuscitation
• CPR
• intubation
• mechanical ventilation
• autonomy