More than 4 million high-risk operations (those that are associated with ≥1% in-hospital mortality) are performed annually in the United States in patients 65 years or older.1 While operative risk has declined over time, many older adults, especially those with multiple chronic conditions, remain at high risk for postoperative morbidity (including loss of independence and/or functional decline) and mortality.2,3 Therefore, the American College of Surgeons and American Geriatric Society jointly recommend patients engage in advance care planning (ACP), which includes documenting a patient’s personal goals and values, treatment preferences, and surrogate decision maker.4 In this study, we determined the prevalence and patient characteristics associated with ACP documentation among elderly adults at any time prior to high-risk surgery.
Identify all potential conflicts of interest that might be relevant to your comment.
Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.
Err on the side of full disclosure.
If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.
Not all submitted comments are published. Please see our commenting policy for details.
Tang VL, Dillon EC, Yang Y, et al. Advance Care Planning in Older Adults With Multiple Chronic Conditions Undergoing High-Risk Surgery. JAMA Surg. Published online December 05, 2018154(3):261–264. doi:10.1001/jamasurg.2018.4647
Customize your JAMA Network experience by selecting one or more topics from the list below.
Create a personal account or sign in to: