Recording of resuscitation status among elderly inpatients at a major rural referral hospital

Dr Stephanie Armstrong, Dr William Boneham, Professor Paul Finucane

Case

Patient autonomy has been a central tenant of medical practice extending to decisions

regarding resuscitation. A point prevalence study was conducted examining the

resuscitation, baseline cognition and functional status of all admitted patients in

the acute services building of Wagga Wagga Rural Referral Hospital. There were

89 patients aged ≥ 65 years in the hospital on the day of the audit. Of these, 28 (31%)

were ‘young-old’ (aged 65-74 years), 37 (42%) were ‘older-old’ (aged 75-84 years)

and 24 (27%) were ‘oldest-old’ (aged ≥ 85 years). Resuscitation status was

documented for 25 (28%) of the 89 patients aged ≥ 65 years. The rate of

documentation of resuscitation status increased with chronological age from 5/28

(18%) in the young-old to 12/37 (32%) in the older-old and 8/24 (33%) in the oldestold.

Rates of documentation of resuscitation status was twice as high on medical units (37%) than on surgical units (18%). This study demonstrates the potential underutilization of formal NFR documentation in a population with a large burden of life limiting comorbidities and high

risk for experiencing sequelae from invasive procedures.