Evidence map›Paper›PMID 41455037›Full record

ArticleDigestive diseases and sciences2026

Advance Directive Completion Among Community-Dwelling Adults with Decompensated Cirrhosis.

Arpan A Patel, Anne M Walling, Rebecca L Sudore, Chi-Hong Tseng, Ron D Hays, Maryam Rahimi, Lisa Gibbs, Neil S Wenger

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Digestive diseases and sciences, 2026. 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

8 authors.

Arpan A PatelDepartment of Medicine and Vatche & Tamar Manoukian, Division of Digestive Diseases, David Geffen School of Medicine, University of California, Los Angeles, CA, USA. ArpanPatel@mednet.ucla.edu.
Anne M WallingDivision of General Internal Medicine and Health Services Research, University of California, Los Angeles, USA.
Rebecca L SudoreDivision of Geriatrics, Department of Medicine, University of California, San Francisco, USA.
Chi-Hong TsengDivision of General Internal Medicine and Health Services Research, University of California, Los Angeles, USA.
Ron D HaysDivision of General Internal Medicine and Health Services Research, University of California, Los Angeles, USA.
Maryam RahimiDivision of General Internal Medicine & Primary Care, Department of Medicine, University of California, Irvine, USA.
Lisa GibbsDivision of Geriatric Medicine and Gerontology, Department of Family Medicine, University of California, Irvine, USA.
Neil S WengerDivision of General Internal Medicine and Health Services Research, University of California, Los Angeles, USA.

Funding

Mentoring Researchers in Advance Care Planning for Underrepresented Older Adults at Risk for Alzheimer’s Disease and Related Dementias and Their CaregiversK24AG054415 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI REBECCA L SUDORE · 2017 to 2026
$1.7M
NIA NIH HHS K24 AG054415Patient-Centered Outcomes Research Institute 1609-36291
6 · The paper itself

Abstract

BACKGROUND AND

aimsAdvance care planning (ACP) is recommended as part of usual care for patients with cirrhosis, but it is uncommonly performed. Little data exist to assess baseline rates of ACP that can be targeted for intervention development and quality improvement initiatives. Therefore, we evaluated advance directive completion among adults with decompensated cirrhosis across three large academic centers serving racially and ethnically diverse populations and described patient factors associated with completion.

methodsWe conducted a secondary analysis of the UC Health Care Planning Study. All patients were identified using a validated, electronic health record algorithm. Our primary outcome was completion of an advance healthcare directive or physician order for life-sustaining treatment. We compared demographics and advance directive completion between patients with decompensated cirrhosis and other advanced chronic illnesses. Bivariate analysis and multivariable logistic regression were performed to assess demographic factors associated with advance directive completion rates.

resultsOf 8707 patients with advanced chronic illnesses, 539 (6%) had decompensated cirrhosis. Patients with decompensated cirrhosis were much less likely to have an advance directive compared to patients with other advanced conditions (22% vs. 34%, p < 0.001). In multivariable analysis, older age (odds ratio [OR]: 1.03 per year, 95% confidence interval [CI]: 1.01-1.05) and Hispanic race/ethnicity (OR: 0.42, 95% CI 0.21-0.84) were significantly associated with advance directive completion.

conclusionAdvance directive completion is low among adults with decompensated cirrhosis. Tailored programs are needed to improve advance directive completion among younger and Hispanic patients with decompensated cirrhosis.

Indexed as

Advance Care PlanningAdvance DirectivesLiver CirrhosisAgedFemaleHispanic or LatinoHumansLogistic ModelsMaleMiddle AgedMultivariate AnalysisAdvance care planningCirrhosisDisparitiesEquityQuality

Identifiers

PMID41455037
PMCPMC13064675

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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.