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Changes in Pediatric End-of-Life Process After the Enforcement of the Act on Life-Sustaining Treatment Decisions-The Experience of a Single Children's Hospital.
Healthcare (Basel)
October 2024
Department of Pediatrics, School of Medicine, Kyungpook National University, Daegu 41944, Republic of Korea.
Article Synopsis
- The Korean LST Decision Act, enacted in February 2018, has transformed end-of-life decision-making for children by promoting structured discussions and decision processes.
- A study comparing patient records before and after the law showed a significant reduction in both total hospitalization and ICU stay durations, along with quicker end-of-life documentation.
- Post-law, there was a notable increase in the use of POLST documents and LST withdrawal decisions, while DNR orders significantly decreased, indicating a shift in how end-of-life care is approached for terminally ill children.
Missed Opportunities for use of Advanced Care Planning and Palliative Care in Open Aortic Surgery.
Ann Vasc Surg
January 2025
Division of Vascular Surgery, Department of Surgery, University of California Davis School of Medicine, Sacramento, CA. Electronic address:
Article Synopsis
- Major vascular surgeries, like open aortic procedures, carry a high risk with a 30-day mortality rate over 6% and complications exceeding 50%, highlighting the need for structured care plans to improve patient outcomes and align medical interventions with care goals.
- A study analyzed data from 192 patients who underwent open aortic surgery between July 2014 and March 2023, focusing on their demographics, advance care planning (ACP), palliative care evaluations, and clinical outcomes.
- The findings revealed that only 16.7% had an ACP document, mostly durable power of attorney, and a very small percentage received palliative care
The Progression of End-of-Life Wishes and Concordance with End-of-Life Care: An Update.
J Palliat Med
August 2024
Supportive Care Services, Kaiser Permanente Northern California, Oakland, California, USA.
Concordance between physician orders for life-sustaining treatment (POLST) preferences and treatment at end-of-life is an important outcome measure of providing patient-centered care. We determine whether the COVID pandemic affected clinician ability to provide goal concordant care and replicate our previous report on care concordance and change in patient preferences over time with a larger sample size. We also investigate the quality of POLST completion to determine the number of documents completed with an advance care planning (ACP) conversation or a decision maker present.
View Article and Find Full Text PDFA Retrospective Analysis of Characteristics Favouring In-Hospital Resuscitation Plan Completion, Their Timing, and Associated Outcomes.
J Clin Med
July 2024
Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, 4 North Terrace, Adelaide, SA 5000, Australia.
Comprehensive resuscitation plans document treatment recommendations, such as 'Not for cardiopulmonary resuscitation'. When created early in admission as a shared decision-making process, these plans support patient autonomy and guide future treatment. The characteristics of patients who have resuscitation plans documented, their timing, and associations with clinical outcomes remain unclear.
View Article and Find Full Text PDFPragmatic implementation of comprehensive dementia care management: The Cedars-Sinai C.A.R.E.S. Program preliminary data.
J Am Geriatr Soc
August 2024
Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, California, USA.
Background: The United States faces a growing challenge with over 6.5 million people living with dementia (PLwD). PLwD and their caregivers struggle with cognitive, functional, behavioral, and psychosocial issues.
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