ArticleAge and ageing2025
Goals of care discussions and treatment limitation decisions in European acute geriatric units: a one-day cross-sectional study.
Article in Age and ageing, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 2 of them syntheses that pooled it.
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Who cites it
3 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Person-centred care models for institutionalised older adults requiring palliative care: an integrative review.BMC geriatrics · 2026Pooled it
- Ceiling of Care in Acute Care Settings: A Concept Analysis.Journal of nursing management · 2026Pooled it
- Resuscitation and goals of care discussions in geriatrics: from perception to clinical practice.European geriatric medicine · 2025Article
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Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIt is important to pursue goal-concordant care and to prevent non-beneficial interventions in older people.
aimTo describe serious illness communication and decision-making practices in hospitalised older people in Europe. SETTING/
participantsData on advance directives, goals of care (GOC) discussions and treatment limitation decisions were collected about patients aged 75-years and older admitted to 23 European acute geriatric units (AGUs).
resultsIn this cohort of 590 older persons [59.5% aged 85 and above, 59.3% female, median premorbid Clinical Frailty Score (CFS) 6], a formal advance directive was recorded in 3.3% and a pre-hospital treatment limitation in 14.0% with significant differences between European regions (respectively P < 0.001 and P = 0.018).Most prevalent GOC was preservation of function (46.8%). GOC were discussed with patients in 64.0%, with families in 73.0%, within the interprofessional hospital team in 67.0% and with primary care in 13.4%. The GOC and the extent to which it was discussed differed between European regions (both P < 0.001). The prevalence of treatment limitation decisions was 53.7% with a large difference within and between countries (P < 0.001). The odds of having a treatment limitation decision were higher for patients with pre-hospital treatment limitation decisions (OR 39.1), residing in Western versus Southern Europe (OR 4.8), belonging to an older age category (OR 3.2), living with a higher number of severe comorbidities (OR 2.2) and higher premorbid CFS (OR 1.3).
conclusionsThere is large variability across European AGUs concerning GOC discussions and treatment limitation decisions. Sharing of information between primary and hospital care about patient preferences is noticeably deficient.
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