Quality of life and resuscitation decisions in elderly patients

Quality of life considerations may be an important factor in medical decisions, but it is not known how well physician's assessments match those of their patients. The authors studied the assessments of elderly inpatients (n = 65) and their physicians (n = 50) concerning patient quality of life and resuscitation decisions for the patients' current health situations and for two hypothetical situations. Physicians rated current patient quality of life more negatively than did patients; differences ranged from 0.35 to 0.80 on a 5-point scale with end points labeled "very poor quality of life" and "possible to have good quality of life." Physicians were also less likely to favor resuscitation in the two hypothetical scenarios (p less than 0.01); differences ranged from 0.66 to 1.40 on a 5-point scale with end points labeled "definitely yes" and "definitely no." In both patient and physician groups, quality of life assessments were significantly correlated with resuscitation decisions for some situations but not for others. These results indicate that elderly patients and their physicians may differ on patient quality of life assessments and that these assessments may be associated with resuscitation decisions.