Registration of advance directives in patients admitted to an intensive care unit: A prevalence study

Advance planning, and its registration in the advance directives document, makes it possible to define goals and preferences, assuring patients of the fulfillment of their wishes, and facilitating decision making by professionals in an end-of-life process. In people admitted to an ICU for treatment, life support or pathologies, communication can be difficult.

To identify how many patients admitted to an ICU had VAD recorded during the years 2019 and 2021, and to study the relationships with age, sex, pathology, population of origin, reason for discharge, and whether the record was before or after admission, and to study whether there were changes in the record after the first year of the pandemic.

Cross-sectional descriptive study carried out in an ICU in Zaragoza during the years 2019 and 2021. The study population consisted of all patients admitted during the study period. A descriptive and bivariate analysis of the variables under study was performed, establishing a confidence level of p < 0.05.

In 2019 there were 694 people admitted, 63% of whom were men, with a mean age of 66 years (SD = 14.5). 1.7% had VAD registered. Only 3 of 12 persons registered their VAD after ICU admission. In 2021 there were 1,137 patients admitted, the majority being men (64.1%), with mean age 63.43 years (SD = 14.6). Of the patients admitted in 2021, 1.8% had VAD recorded. Only 4 people out of 21 registered VAD after admission to the ICU. Only a relationship could be established between having registered VAD and origin in the year 2021, being more frequent in those who lived in the city.

The registration of VAD in patients admitted to our service was scarce, with no differences observed between the years 2019 and 2021. Most had the DVA registered before admission to the ICU, so it is considered important to raise awareness of making adequate planning of care wishes in the last days of life.