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Differences in end-of-life care decision making between patients with and without cancer
In Ki Park1, Hyun Jung Jun2, Sung Jae Park1
1Department of internal medicine, Seoul Medical Center, Seoul, Republic of Korea.
Background:
Most patients and families do not want invasive life-sustaining procedures when recovery is unlikely. We compared the clinical features of advance directives (ADs) of patients with and without cancer.
Methods:
The ADs were obtained from retrospectively reviewing electronic medical records of 699 consecutive patients who died from April 2011 to July 2012.
Results:
Patients with cancer were more likely to have written ADs: 265 (85.8%) patients with cancer and 277 (71.0%) noncancer patients (P < .001). Significantly more noncancer patients were in the intensive care unit, indicating that they had received or were receiving invasive treatments. Noncancer patients requested life-sustaining treatment more frequently but symptom control less frequently than patients with cancer.
Conclusion:
Advance care planning in patients with incurable, noncancer disease is important to guarantee patient autonomy at the end of life.
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