Baseline characteristics of patients completing discussions about goals of care (n = 37)
| Baseline characteristic | No. (%) of patients* |
|---|---|
| Age, yr, mean ± SD | 86.7 ± 4.7 |
| Sex (female:male patients) | 16:21 |
| Residence | |
| Community | 32 (86.5) |
| Long-term care facility | 3 (8.1) |
| Retirement home | 2 (5.4) |
| “QoL in last two weeks?” (25)† | |
| Not answered | 14 (37.8) |
| Very good | 7 (18.9) |
| Good | 12 (32.4) |
| Neither | 1 (2.7) |
| Poor | 2 (5.4) |
| Very poor | 1 (2.7)** |
| “Satisfied with health?” (25)† | |
| Not answered | 14 (37.8) |
| Very satisfied | 2 (5.4) |
| Satisfied | 12 (32.4) |
| Neither | 2 (5.4) |
| Dissatisfied | 6 (16.2) |
| Very dissatisfied | 1 (2.7)** |
| Clinical frailty score, mean ± SD (24) | 4.5 ± 1.8 |
| Charlson Comorbidity Index score, mean ± SD (36) | 4.6 ± 3.4 |
| Expected hospital standardized mortality ratio, mean ± SD (26) | 29.8 ± 14.0 |
| Admission diagnoses (26) | |
| Pneumonia | 8 (21.6) |
| Fracture of femur | 7 (18.9) |
| Sepsis | 4 (10.8) |
| Heart failure | 3 (8.1) |
| Acute renal failure | 2 (5.4) |
| Unspecified dementia | 2 (5.4) |
| Other‡ | 11 (29.7)** |
| Most responsible physician | |
| Hospitalist | 12 (32.4) |
| Internal medicine specialist (or internist) | 14 (37.8) |
| Surgeon (all types) | 9 (24.3) |
| Hematology and oncology specialist | 2 (5.4)** |
| “Avoid attachment to machines?” (19), (34)§ | |
| Not answered | 17 (45.9) |
| 10 (very important) | 7 (18.9) |
| 8 | 1 (2.7) |
| 7 | 2 (5.4) |
| 6 | 1 (2.7) |
| 5 | 6 (16.2) |
| 4 | 1 (2.7) |
| Unsure | 2 (5.4) |
| “Preserve life at all costs?” (19), (31)§ | |
| Not answered | 17 (45.9) |
| 10 (very important) | 3 (8.1) |
| 9 | 1 (2.7) |
| 8 | 2 (5.4) |
| 5 | 2 (5.4) |
| 4 | 2 (5.4) |
| 3 | 2 (5.4) |
| 2 | 2 (5.4) |
| 1 (not important) | 5 (13.5) |
| Unsure | 1 (2.7) |
| Physician order form for life-sustaining treatment status¶ | |
| Not completed | 22 (59.4) |
| Invasive and CPR | 11 (29.7) |
| Invasive and no CPR | 1 (2.7) |
| Minimally invasive and no CPR | 3 (8.1) |
Note: CPR = cardiopulmonary resuscitation, SD = standard deviation, SDM = substitute decision-maker, QoL = quality of life.
↵* Unless otherwise specified.
↵† Based on patient or SDM response to: “How would you rate your quality of life in the last 2 weeks prior to admission to hospital?” or “How satisfied are you with your health in the last 2 weeks prior to admission to hospital?”, respectively.
↵‡ Eleven diagnoses with a frequency of 1.
↵§ Based on patient or SDM response to “How important is it that I avoid being attached to machines and tubes?” or “How important is the belief that life should be preserved at all costs?”, respectively.
↵¶ If physician order form for life-sustaining treatment status is not completed in prediscussions about goals of care, treatment of life-threatening illnesses defaults to invasive and CPR.
↵** Rounding error accounts for total of 99.9%.