Elderly patients and resuscitation: Advanced age is not a factor

EDITOR, - Marguerite E Hill and colleagues and R Morgan and colleagues have highlighted the difference between doctors and patients regarding resuscitation decision making.^1,2 We sought the opinions of doctors and nurses regarding 100 elderly patients admitted through casualty in a district general hospital. All patients were over 70 (mean age 80 years); 59 were admitted under the care of a general physician and 41 a geriatrician. There was no formal resuscitation policy.

A questionnaire was completed by the junior doctor (senior house officer or registrar) and senior ward nurse in all cases and by the consultant in 88 cases. Each was asked whether the patient that had taken place, and the importance of various factors (graded on a scale of 1-5) in making a decision.

There was no significant difference, by matched analysis, between junior and senior doctors in the likelihood of making a decision for resuscitation; consultants felt that 55/88 (63%) should be resuscitated and juniors 63/100 (63%). In 23/88 (26%) cases there was disagreement between junior and senior doctors. Nurses felt that 51/100 (51%) should be resuscitated. In only 53/88 (60%) cases was there agreement among all three groups. There was no difference between general physicians and geriatricians.

In only 7/33 (21%) cases, when the consultant felt that resuscitation was not appropriate, had there been any discussion of resuscitation with either the …