Acute Renal Failure, Congestive Heart Failure, Infections, Sepsis, Stroke
Conditions
Brief summary
There is evidence to suggest that patients make different end-of-life decisions if they understand the risks, benefits and alternatives of CPR and mechanical ventilation. This study will examine whether evidence-based informed consent impacts patients choices and healthcare outcomes compared to routine care.
Interventions
OTHERScript and CPR/Mechanical ventilation video.
Patients will be randomized to receive the script (see addendum) plus video. Video was produced by and is the property of the study investigators.
Sponsors
Jewish Hospital, Cincinnati, Ohio
Study design
Allocation
RANDOMIZED
Intervention model
SINGLE_GROUP
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
65 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* All patients * ≥65 yrs * Admitted to the hospitalist Medicine Service
Exclusion criteria
* Patients who have pre-existing, pan-institutional (e.g. to be applied at nursing homes and hospitals) orders of no CPR and/or no mechanical ventilation will be screened (demographic and outcomes data collected) but NOT randomized. * Patients already receiving critical care on admission will also be excluded
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of patients opting out of routine care - no intubation | 48 hours | Number of patients in each group who opt out of intubation 48 hours after admission. |
| Number of patients opting out of routine care - no CPR | 48 hours | Number of patients in each group who opt out of CPR within 48 hours of admission. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| 90 day mortality | 90 days | Number of deaths in each group in 90 days. |
| Hospital Mortality | Length of patient's hospital stay | Number of deaths in each group in the hospital |
| Number of patients undergoing intubation | Length of patient's hospital stay | Number of patients in each group who undergo intubation during their hospital stay. |
| Number of patients undergoing CPR | Length of patient's hospital stay | Number of patients in each group who undergo CPR during their hospitalization. |
| 30-day mortality | 30 days | Number of deaths in each group after 30 days. |
Countries
United States
Outcome results
None listed