Crucial Conversations for High-Risk Populations before Surgery: Advance Care Planning in a Preoperative Setting

If you need an accessible version of this item, please submit a remediation request.
Date
2021-10-06
Language
American English
Embargo Lift Date
Committee Members
Degree
Degree Year
Department
Grantor
Journal Title
Journal ISSN
Volume Title
Found At
Mary Ann Liebert, Inc.
Abstract

Background: High-risk patients undergoing elective surgery are at risk for perioperative complications, including readmissions and death. Advance care planning (ACP) may allow for preparation for such events.

Objectives: (1) To assess the completion rate of advance directives (ADs) and their association with one year readmissions and mortality (2) to examine clinical events for decedents.

Design: This is an observational cohort study conducted through chart review.

Setting/Subjects: Subjects were 400 patients undergoing preoperative evaluation for elective surgery at two hospitals in the United States.

Measurements: The prevalence of ADs at the time of surgery and at one year, readmissions, and mortality at one year were determined.

Results: Three-hundred ninety patients were included. In total, 102 (26.4%) patients were readmitted, yet did not complete an AD. Seventeen (4.4%) patients filed an AD during follow-up. Nineteen patients died and mortality rate was 4.9%. There was a significant association between completing an AD before death. Of the decedents, seven (37%) underwent resuscitation, but only four had ADs.

Conclusions: Many high-risk surgical patients would benefit from ADs before clinical decline. Preoperative clinics present a missed opportunity to ensure ACP occurs before complications arise.

Description
item.page.description.tableofcontents
item.page.relation.haspart
Cite As
Patel R, Torke A, Nation B, et al. Crucial Conversations for High-Risk Populations before Surgery: Advance Care Planning in a Preoperative Setting. Palliat Med Rep. 2021;2(1):260-264. Published 2021 Oct 6. doi:10.1089/pmr.2021.0015
ISSN
Publisher
Series/Report
Sponsorship
Major
Extent
Identifier
Relation
Journal
Palliative Medicine Reports
Source
PMC
Alternative Title
Type
Article
Number
Volume
Conference Dates
Conference Host
Conference Location
Conference Name
Conference Panel
Conference Secretariat Location
Version
Final published version
Full Text Available at
This item is under embargo {{howLong}}