Evidence map›Paper›PMID 30251423›Full record

ArticleJournal of the American Geriatrics Society2018

'Til Death Do Us Part: End-of-Life Experiences of Married Couples in a Nationally Representative Survey.

Ashwin A Kotwal, Emily Abdoler, L Grisell Diaz-Ramirez, Amy S Kelley, Katherine A Ornstein, W John Boscardin, Alexander K Smith

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of the American Geriatrics Society, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.7field-weighted citation impact, top 25% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 9 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 1 country.

Ashwin A KotwalDivision of Geriatrics, Department of Medicine, University of California, San Francisco, San Francisco, California.
Emily AbdolerDivision of Geriatrics, Department of Medicine, University of California, San Francisco, San Francisco, California.
L Grisell Diaz-RamirezDivision of Geriatrics, Department of Medicine, University of California, San Francisco, San Francisco, California.
Amy S KelleyDepartment of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.
Katherine A OrnsteinDepartment of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.
W John BoscardinDivision of Geriatrics, Department of Medicine, University of California, San Francisco, San Francisco, California.
Alexander K SmithDivision of Geriatrics, Department of Medicine, University of California, San Francisco, San Francisco, California.
University of California, San Francisco · USIcahn School of Medicine at Mount Sinai · US

Funding

Developing prognostic models for life expectancy and geriatric outcomesR01AG047897 · NIA · NORTHERN CALIFORNIA INSTITUTE/RES/EDU · PI LEE, SEI, SMITH, ALEXANDER KELIIMOEANU · 2015 to 2018
$1.7M
Downstream effects of end-of-life patient treatment intensity on family membersK01AG047923 · NIA · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI ORNSTEIN, KATHERINE A · 2014 to 2018
$581k
NIA NIH HHS K01 AG047923NIA NIH HHS R01 AG047897The National Institute on Aging provided K01AG047923The National Institute on Aging provided R01AG047897
6 · The paper itself

Abstract

objectivesTo determine whether end-of-life (EOL) experiences in the first spouse in a marriage are associated with EOL experiences in the other spouse.

designNationally representative, longitudinal survey.

settingHealth and Retirement Study, Waves 1992-2012 linked to Medicare claims

participantsCommunity-dwelling older adults who died (N=4,558), representing 2,279 married heterosexual couples. MEASUREMENTS: We examined 3 EOL experiences: enrollment in hospice for >3 days before death, lack of advance care planning (ACP) before death, and intensive care unit (ICU) use during the last 30 days of life. We used multiple logistic regression to determine whether the EOL experience of the first spouse was a significant predictor of the EOL experience of the second spouse after adjusting for demographic characteristics, socioeconomic status, health status, and time between the first and second spouses' deaths.

resultsFirst spouses who died were on average 80 years old, and 62% were male; second spouses were on average 85 years old, and 62% were female. After adjustment, second spouses were more likely to use hospice if the first spouse used hospice (odds ratio (OR)=1.68, 95% confidence interval (CI)=1.29-2.20). Second spouses were less likely to have ACP when the first spouse did not have ACP (OR=2.91, 95% CI=2.02-4.21). Hospice and ACP associations were stronger when deaths were closer in time to one another (p-value for interaction < .05). Second spouses were more likely to use ICU services if the first spouse did (OR=1.80, 95% CI=1.27-2.55).

conclusionsThe EOL experiences of older spouses are strongly associated, which may be relevant when framing ACP discussions. J Am Geriatr Soc 66:2360-2366, 2018.

Indexed as

Advance Care PlanningAged, 80 and overFemaleHospice CareHumansIndependent LivingIntensive Care UnitsLongitudinal StudiesMaleMarriageMedicareSpousesSurveys and QuestionnairesTerminal CareUnited Statesadvance care planninghospiceintensive care unitmarriageolder adults

Identifiers

PMID30251423
PMCPMC6289600
OpenAlexW2893300634

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.