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Does anyone ever expect to die?

Mhr Anstey1, N Watts2, N Orford3

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This summary is machine-generated.

Less than 9% of intensive care unit patients have advance directives. This study suggests targeting high-risk patients for end-of-life discussions to improve care planning.

Keywords:
palliative care, end-of-life issues, anaesthesia and intensive care

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Area of Science:

  • Critical Care Medicine
  • Palliative Care
  • Health Services Research

Background:

  • Critically ill patients admitted to intensive care units (ICUs) are often the sickest in hospitals.
  • Many ICU patients have severe chronic conditions and a high likelihood of mortality.
  • Understanding patients' end-of-life wishes is crucial for appropriate care.

Purpose of the Study:

  • To assess the availability of advance directives among ICU patients.
  • To identify strategies for improving end-of-life care planning in ICUs.

Main Methods:

  • Prospective, single-day observational study.
  • Data collected from 46 Australian hospitals in 2014-2015.
  • Utilized the Australian and New Zealand Intensive Care Society Clinical Trials Group Point Prevalence Program data.

Main Results:

  • Only 8.8% (51/577) of ICU patients had an available advance directive.
  • This highlights a significant gap in documented end-of-life preferences for critically ill patients.

Conclusions:

  • Systematically engaging 'high risk of dying' patient groups in outpatient settings for goals of care conversations is recommended.
  • Increased societal dialogue regarding end-of-life wishes is necessary to improve patient-centered care in critical care settings.