Observational studyBMC palliative care2026
Advance care planning uptake in the severely frail.
Observational study in BMC palliative care, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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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.
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.
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Who cites it
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundOlder adults with severe frailty (Clinical Frailty Scale [CFS] 7-9) have high short-term mortality and are often approaching the end of life. Despite this, uptake of Advance Care Planning (ACP) remains low. This study aimed to examine the rate and timing of ACP referral and completion among hospitalized patients with severe frailty.
methodsWe conducted a retrospective observational study of patients aged ≥ 65 years with documented CFS scores of 7-9 admitted to the geriatric medicine wards of a public tertiary hospital in Singapore between July and September 2024. The primary outcome was the proportion of patients with completed ACPs. Secondary outcomes included ACP referral and completion rates, time from admission to ACP referral and completion, mortality at 30 days and 6 months, stated care preferences, and place of death. Descriptive statistics were used to summarize patient characteristics and outcomes.
resultsAmong 86 patients with severe frailty (mean age 84.8 years; 72.1% female), 14 (16.3%) had completed ACPs prior to admission. Of the remaining 72 patients, 17 (23.6%) were referred for ACP within 90 days, of whom 6 (35.3%) completed ACP discussions. In-hospital mortality was 5.8%, and 6-month mortality was 31.4%. Among patients who died within 6 months, 69.5% died in hospital. Patients with completed ACPs more frequently died at home or with home hospice care.
conclusionsOur study demonstrates that hospitalized patients with severe frailty have high short-term mortality but low rates of ACP referral and completion. Earlier and systematic initiation of ACP at the point of frailty identification may improve alignment of end-of-life care with patient preferences and reduce unwanted hospital deaths.
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