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Knowledge of CPR and Code Status Discussions in Traumatically Injured Older Adults: Does Health Literacy Matter?
Mokunfayo O Fajemisin1,2,3, Ashna S Karpe1, Stephanie Martinez Ugarte1,2,3
1Department of Surgery, McGovern Medical School at The University of Texas Health Science Center (UTHealth Houston), Houston, TX, USA.
Summary
Older adults injured in trauma often lack understanding of cardiopulmonary resuscitation (CPR) and code status discussions. Low health literacy further limits their advance care planning knowledge.
Area of Science:
- Geriatric Trauma
- Medical Education
- Public Health
Background:
- Code Status Discussions (CSDs) and cardiopulmonary resuscitation (CPR) understanding are understudied in older adults experiencing traumatic injuries.
- Limited health literacy may impede effective advance care planning and decision-making in this vulnerable population.
Purpose of the Study:
- To investigate the understanding of CPR and code status among traumatically injured older adults and their families.
- To determine the association between health literacy levels and knowledge of advance care planning in this demographic.
Main Methods:
- A survey was administered to injured adults aged 65 and older, or their legal surrogates.
- Data collected included baseline code status, health literacy assessment, and prior CPR discussions.
- Univariate and multivariable analyses were performed to identify significant associations.
Main Results:
- 55% of the 201 respondents exhibited low health literacy.
- Only 38% reported having CPR discussions, and 21% were explicitly asked about code status upon admission.
- Lower health literacy correlated with reduced engagement in seeking CPR information and lower confidence in CPR effectiveness.
Conclusions:
- Traumatically injured older adults and their surrogates demonstrate a significant deficit in understanding CPR and code status.
- Low health literacy is a key factor associated with poor knowledge and engagement in advance care planning for this population.
- Interventions to improve health literacy and CSDs are crucial for geriatric trauma patients.
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