Evidence map›Paper›PMID 34047202›Full record

ArticleThe American journal of hospice & palliative care2022

Preoperative Advance Care Planning for Older Adults Undergoing Major Abdominal Surgery.

Josh Bleicher, Lauren E McGuire, Riann B Robbins, Jordan E Johnson, Sarah Fischbuch, Sumati Gupta, Anna C Beck, Jessica N Cohan

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The American journal of hospice & palliative care, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
1.6field-weighted citation impact, top 17% of its field
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

8 citing papers in PubMed, 1 synthesis or guideline pooled it, 14 citations in OpenAlex.

  1. Pooled it
  2. Thematic Analysis of Barriers to Completion of a Healthcare Proxy at a Comprehensive Cancer Center.Journal of cancer education : the official journal of the American Association for Cancer Education · 2026
    Article
  3. Article
  4. Ensuring Goal-Aligned Care in a Busy Surgical Practice.Seminars in colon & rectal surgery · 2024
    Article
  5. Article
  6. Article
  7. Article
  8. 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 at 1 institution in 1 country.

Josh BleicherUniversity of Utah, Department of Surgery, Salt Lake City, UT, USA.ORCID https://orcid.org/0000-0001-6137-4426
Lauren E McGuireUniversity of Utah, Department of Surgery, Salt Lake City, UT, USA.
Riann B RobbinsUniversity of Utah, Department of Surgery, Salt Lake City, UT, USA.
Jordan E JohnsonUniversity of Utah, Department of Surgery, Salt Lake City, UT, USA.
Sarah FischbuchHuntsman Cancer Institute at the University of Utah, Department of Population Sciences, Salt Lake City, UT, USA.
Sumati GuptaHuntsman Cancer Institute at the University of Utah, Department of Medical Oncology, Salt Lake City, UT, USA.
Anna C BeckHuntsman Cancer Institute at the University of Utah, Department of Medical Oncology, Salt Lake City, UT, USA.
Jessica N CohanUniversity of Utah, Department of Surgery, Salt Lake City, UT, USA.
University of Utah · US

Funding

Utah Center for Clinical and Translational ScienceUL1TR002538 · NCATS · UNIVERSITY OF UTAH · PI HESS, RACHEL, MAJERSIK, JENNIFER JUHL · 2018 to 2022
$26.0M
University of Utah Center for Clinical and Translational ScienceUL1TR001067 · NCATS · UNIVERSITY OF UTAH · PI DERE, WILLARD H., HESS, RACHEL · 2013 to 2017
$19.8M
NCATS NIH HHS UL1 TR002538
6 · The paper itself

Abstract

backgroundAdvance care planning (ACP) is recommended for older patients undergoing surgery. ACP consists of creating advance directives (ADs), identifying surrogate decision makers (SDMs), and documenting goals of care. We identified factors associated with documentation of preoperative ACP to identify opportunities to optimize ACP for older surgical patients.

methodsThis was a retrospective study of surgical patients ≥70 years old who underwent elective, high-risk abdominal procedures between 01/2015-08/2019. Clinical data were obtained from our institution's National Surgical Quality Improvement Project database. ACP metrics were extracted from the electronic medical record. We analyzed the data to identify patient factors associated with ACP metrics. We also analyzed whether ACP was more frequent for patients who experienced postoperative complications or death.

results267/1,651 patients were included. 97 patients (36%) had an AD available on the day of surgery, 57 (21%) had an SDM identified, and 31 (12%) had a documented goals of care conversation. On multivariable analysis, older age and white race were associated with an increased likelihood of having an AD available on the day of surgery. Women were 1.7 times more likely to have an SDM (p = 0.02). No patient or surgeon factors were significantly associated with goals of care documentation. ACP was not performed more frequently in patients who experienced postoperative complications or death.

conclusionIn this series, ACP was not routinely documented for older patients undergoing major surgery. ACP was not more frequent in patients who experienced complications or death, demonstrating the importance of universal preoperative ACP in older patients.

Indexed as

Advance Care PlanningAdvance DirectivesAgedCommunicationDocumentationFemaleHumansRetrospective Studiesadvance care planninggeriatric medicinegeriatric surgerypalliative careperioperative caresurgery

Identifiers

PMID34047202
PMCPMC10512745
OpenAlexW3165496631

What Socratic holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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 Socratic graph.