title: Advance directive use among patients undergoing selected high-risk surgical procedures.
abstract: Since 1991, the Patient Self-Determination Act has required that all patients entering Medicare-reimbursed institutions be asked if they have an advance directive (AD) and be given information about advance directives if they do not have one. Patients undergoing elective high-risk surgery for diseases with a poor prognosis were identified as being most likely to benefit from an AD. The charts of patients being explored for possible pancreaticoduodenectomy or esophagectomy at a tertiary referral hospital in 1996 were retrospectively reviewed. Few patients had an AD, and there was little evidence that the presence of an AD affected patient care.
authors.affiliation: Northwestern University, Chicago, IL, USA.
authors.forename: P
authors.initials: P
authors.lastname: Angelos
authors.forename: C
authors.initials: C
authors.lastname: Johnston
mesh_terms: D016223:Advance Directives / Q000331:legislation & jurisprudence*; D003625:Data Collection; D017558:Elective Surgical Procedures; D016629:Esophagectomy; D006801:Humans; D008485:Medical Audit; D006278:Medicare / Q000331:legislation & jurisprudence; D016577:Pancreaticoduodenectomy; D019726:Patient Self-Determination Act; D010817:Physician-Patient Relations; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D014481:United States