Evidence map›Paper›PMID 40940663›Full record

ArticleScandinavian journal of trauma, resuscitation and emergency medicine2025

The role of specialized outpatient palliative care in emergency advance directives: fewer hospitalizations, greater alignment with patient wishes.

Yann-Nicolas Batzler, Jannis Wetzlar, Dirk Wildner, Manuela Schallenburger, Theresa Tenge, Marc Stefaniak, Miguel Angel Méndez Delgado, Jacqueline Schwartz, Lennert Böhm, Michael Bernhard and 1 more

Abstract read
In one paragraph

Article in Scandinavian journal of trauma, resuscitation and emergency medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. Article
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

11 authors.

Yann-Nicolas BatzlerCentre of Palliative Care and Pediatric Pain, Faculty of Medicine, Saarland University Medical Center and Saarland University, Homburg/Saar, Germany.
Jannis WetzlarInterdisciplinary Center for Palliative Medicine, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany.
Dirk WildnerInterdisciplinary Center for Palliative Medicine, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany. dirk.wildner@med.uni-duesseldorf.de.
Manuela SchallenburgerInterdisciplinary Center for Palliative Medicine, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany.
Theresa TengeCentrum für Integrierte Onkologie Aachen Bonn Cologne Düsseldorf (CIO ABCD), Aachen, Bonn, Köln, Düsseldorf, Deutschland.
Marc StefaniakInterdisciplinary Center for Palliative Medicine, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany.
Miguel Angel Méndez DelgadoDepartment of Anesthesiology, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany.
Jacqueline SchwartzInterdisciplinary Center for Palliative Medicine, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany.
Lennert BöhmEmergency Department, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany.
Michael BernhardEmergency Department, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany.
Martin NeukirchenInterdisciplinary Center for Palliative Medicine, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

contextSpecialized outpatient palliative care (SOPC) aims at relieving symptoms and providing psychosocial aid in the outpatient setting. SOPC also supports patients in setting up advance directives so that their will is respected in emergency situations.

objectivesThe aim of this study is to analyze the impact of SOPC on the completion of advance care directives with the focus on medical emergency identification (ID) cards (= living will in a credit card format on yellow paper) and their impact on hospital admissions.

methodsAll adult patients who were admitted to the SOPC service at a tertiary care center in Germany between 07/2022 and 06/2023 were included in this retrospective cohort study. Demographic data, level of care, information on advance care directives, hospitalizations, adherence to patient wishes, and tumor specific treatments were collected. The data were analyzed using descriptive and inferential measures.

resultsDuring the study period, 359 patients were included (52.0% female, mean age 74 ± 13 years). A medical emergency ID card was set up by 32.6% (n = 117/359). It was significantly more likely to be created during SOPC than prior to SOPC involvement (before: 20%, after: 80%; p < 0.05). Patients who expressed not wanting to be admitted to hospital in their medical emergency ID card saw significantly less hospital admissions (p < 0.05).

conclusionSOPC supports patients in setting up medical emergency ID cards. These help in respecting patients’ wishes and prevent unwanted admissions to hospitals, thereby reducing strain on emergency services and emergency departments.

Indexed as

Advance DirectivesAmbulatory CareHospitalizationPalliative CarePatient PreferenceAgedAged, 80 and overFemaleGermanyHumansMaleMiddle AgedRetrospective StudiesAdvance directivesHealth care providersHome carePalliative carePalliative emergency careSpecialized outpatient palliative care

Identifiers

PMID40940663
PMCPMC12427111

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Registered trials

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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.