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Utilizing the Modified T-Maze to Assess Functional Memory Outcomes After Cardiac Arrest

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Advance Care Planning Before and After In-Hospital Cardiac Arrest.

Alexander Polyak¹, Phillip Ryan Tacon¹, Zachary Krom²

¹Cedars-Sinai Medical Center, Los Angeles, CA, USA.

The American Journal of Hospice & Palliative Care

|March 20, 2025

Summary

Advance care planning (ACP) discussions for hospitalized patients experiencing cardiac arrest were more likely for older, White patients with higher GO-FAR scores. Non-White patients and those with poor predicted survival had lower ACP rates.

Keywords:

advanced care planning advanced health care planning cardiac arrest critical care outcomes end of life goals of care in-hospital cardiac arrest in-hospital mortality return of spontaneous circulation

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Area of Science:

Medical research
Clinical outcomes
Patient care

Background:

In-hospital cardiac arrest (IHCA) presents significant morbidity and mortality.
Advance care planning (ACP) is crucial for patient-centered care, especially for high-risk individuals.

Purpose of the Study:

To investigate clinical factors associated with ACP discussions in patients who experience IHCA.
To identify disparities in ACP documentation among diverse patient populations.

Main Methods:

Single-center retrospective cohort study.
Analysis of clinical characteristics and their association with ACP documentation before IHCA.
Multivariate regression modeling to identify independent predictors of ACP.

Main Results:

Older age, White race, higher GO-FAR score, ICU admission, longer hospitalization, and normal mental status were associated with increased ACP documentation.
A trend of lower ACP documentation was observed for non-White patients.
56% of patients with predicted low survival likelihood lacked prior ACP documentation.

Conclusions:

Factors like age, ICU location, hospitalization duration, GO-FAR score, and mental status influence ACP likelihood.
Disparities in ACP documentation exist for non-White patients.
Low ACP rates in high-risk patients highlight the need for standardized prognostication and universal ACP engagement.