ArticleBMC geriatrics2021
Life-sustaining treatment preferences in older patients when referred to the emergency department for acute geriatric assessment: a descriptive study in a Dutch hospital.
Article in BMC geriatrics, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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6 citing papers in PubMed.
- Older patients and intensive care: factors that influence patients decisions on life sustaining measures.BMC geriatrics · 2026Article
- A glimpse of the end-of-life of people with Parkinson's disease and atypical parkinsonism: A descriptive analysis of electronic health records.Journal of Parkinson's disease · 2025Article
- The severely injured older patient: identifying patients at high risk for mortality using the Dutch National Trauma Registry.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Article
- Decisions about the limitations of life-sustaining treatment for acutely admitted older patients: a retrospective study of a Danish patient cohort.BMC geriatrics · 2024Article
- Bibliometric Analysis of Comprehensive Geriatric Assessment from 2004 to 2023.Journal of multidisciplinary healthcare · 2024Article
- Recommendation-making in the emergency department: A qualitative study of how Canadian emergency physicians guide treatment decisions about resuscitation in critically ill patients.Journal of the American College of Emergency Physicians open · 2023Article
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8 authors.
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Abstract
backgroundIn many cases, life-sustaining treatment preferences are not timely discussed with older patients. Advance care planning (ACP) offers medical professionals an opportunity to discuss patients' preferences. We assessed how often these preferences were known when older patients were referred to the emergency department (ED) for an acute geriatric assessment.
methodsWe conducted a descriptive study on patients referred to the ED for an acute geriatric assessment in a Dutch hospital. Patients were referred by general practitioners (GPs), or in the case of nursing home residents, by elderly care physicians. The referring physician was asked if preferences regarding life-sustaining treatments were known. The primary outcome was the number of patients for whom preferences were known. Secondary outcomes included which preferences, and which variables predict known preferences.
resultsBetween 2015 and 2017, 348 patients were included in our study. At least one preference regarding life-sustaining treatments was known at referral in 45.4% (158/348) cases. In these cases, cardiopulmonary resuscitation (CPR) policy was always included. Preferences regarding invasive ventilation policy and ICU admission were known in 17% (59/348) and 10.3% (36/348) of the cases respectively. Known preferences were more frequent in cases referred by the elderly care physician than the GP (P < 0.001).
conclusionsIn less than half the patients, at least one preference regarding life-sustaining treatments was known at the time of referral to the ED for an acute geriatric assessment; in most cases it concerned CPR policy. We recommend optimizing ACP conversations in a non-acute setting to provide more appropriate, desired, and personalized care to older patients referred to the ED.
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