Most of the time, it is not "useful" to resuscitate people over 80 years old in case of cardiac arrest, according to research done by two Belgian doctors.
Of all people 80 years and older who have been resuscitated, only 2% survive, often with serious problems as a result. Especially in nursing homes, resuscitation is rarely useful, according to research that was published in De Standaard on Monday.
Despite the low success rate, over half of health care providers consider a resuscitation attempt for people older than 80 appropriate. 18.5% of carers are unsure, and about the same percentage considers resuscitation at that age unsuitable.
The debate is urgent, according to Patrick Druwé (UZ Gent - Ghent University Hospital) and Koen Monsieurs (UZA - Antwerp University Hospital) in a study they published in the American "Journal of American Geriatrics Society" journal.
"We need to look more at objective criteria before we decide to start such resuscitation, and weigh up the patient's real chances against the damage we can do through resuscitation," said Dr Patrick Druwé on "De ochtend" on Radio 1.
"If you're on the train next to an unknown eighty-something going into cardiac arrest, you're obviously going to try to resuscitate. You always do that at the slightest doubt," said Druwé. "But if you know that that person's medical condition is already bad, it is better not to resuscitate. We're not doing such a patient any favours with CPR," he added.
"We're not saying it's not-done by definition. If a number of conditions are met, there may be a - limited - chance of meaningful survival," the doctors said, reports VRT.
If the heart still has a "shockable rhythm" (meaning it still has a certain electrical activity, and it qualifies for electric shock), a witness who can provide information about the conditions is present, CPR is initiated immediately, and the patient was in good health before the cardiac arrest, resuscitation can still be meaningful, the doctors said.
However, if a doctor empathically explains that resuscitation is pointless, the family will agree, according to Druwé. "It's about putting our energy into those patients who do have a chance. We can do better for that group in Flanders," he said.
Maïthé Chini
The Brussels Times
