Haemodialysis patients' views on their resuscitation status.
BACKGROUND
Guidelines on cardiopulmonary resuscitation (CPR) recommend that decisions about resuscitation are part of every patient's care plan. We aimed to ascertain the initial views of a haemodialysis cohort in the UK regarding their CPR status in the event of an in-hospital cardiac arrest not related to dialysis.


METHODS
During outpatient clinic follow-up between January and March 2001, 66 haemodialysis patients were interviewed by one of two interviewers. A standard interview format was used, which included information on complications and outcome of CPR in haemodialysis patients. Patients had no prior opportunity to discuss the issue with a third party.


RESULTS
Fifty patients (76%) wished to receive CPR. Five patients decided against CPR, of whom two were depressed. Six patients were undecided. Five patients were excluded from the analysis because of lack of mental capacity or language difficulties. Patients who wished to receive CPR were significantly younger (59 +/- 16 vs 74 +/- 10 years, respectively; P < 0.01) and had a significantly higher serum albumin level compared with those who did not opt for CPR or were undecided. There was no difference in gender, comorbidity, length of time on dialysis, proportion of patients with adequate dialysis and mean haemoglobin level between those who wished CPR and those who did not.


CONCLUSIONS
The majority of haemodialysis patients wished to receive CPR. These patients were younger than those who did not opt for CPR. Clearer strategies on third-party consultation and follow-up interviews are needed to guarantee that patients' wishes are respected at all times.
Ostermann
Maria E
ME
Department of Renal Medicine & Transplantation, St George's Hospital, London, UK. marlies@ostermann.freeserve.co.uk
Nelson
Stephen R
SR
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D016887:Cardiopulmonary Resuscitation; D015897:Comorbidity; D003657:Decision Making; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000523:psychology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000523:psychology*; D016414:Resuscitation Orders