Documentation of discussions about prognosis with terminally ill patients

摘要: Abstract Purpose Previous studies have suggested the importance of communicating with patients about prognosis at end life, yet prevalence, content, and consequences such communication not been fully investigated. The purposes this study were to estimate proportion terminally ill inpatients documented discussions prognosis, describe nature correlates discussions, assess association between subsequent advance care planning. Subjects methods Inpatients (n = 232) least 65 years old who had brain, pancreas, liver, gall bladder, or inoperable lung cancer randomly selected from six chosen community hospitals in Connecticut. presence content advanced planning efforts, sociodemographic clinical factors ascertained by comprehensive review medical records using a standardized abstraction form. Results Discussions 89 (38%) patients. Physicians both present during discussion 46 (52%) these cases. Time until expected death was infrequently documented. Having associated life-sustaining treatments (adjusted odds ratio [OR] 5.8; 95% confidence interval [CI]: 2.8 12.0) having do-not-resuscitate order OR=2.2; CI: 1.1 4.2). Conclusions Among cancer, as charts are infrequent limited scope. In some cases, may be important catalysts for patient family preferences regarding treatment future care.