Table 1.
Comparison of Patient Characteristics and Hospital Events by Presence of any Advance Directive (Surrogate Decision Maker or Living Will) in the Electronic Medical Record
| Advance directive in EMR | ||||
|---|---|---|---|---|
| Total | Yes | No | p value | |
| N = 400 | N = 64 (16.0%) | N = 336 (84.0%) | ||
| Preoperative patient characteristics | ||||
| Age ≥ 65, n (%) | 140 (35.0) | 35 (54.7) | 105 (31.3) | 0.0005 |
| Sex, male n (%) | 193 (48.3) | 24 (37.5) | 169 (50.3) | 0.0756 |
| Race, white vs. non-white, n (%) | 339 (84.8) | 56 (87.5) | 283 (84.2) | 0.5744 |
| Hospital 1 vs. hospital 2, n (%) | 199 (49.8) | 36 (56.3) | 163 (48.5) | 0.2772 |
| Insurance: Medicaid, n (%) | 46 (11.5) | 7 (10.9) | 39 (11.6) | 1.0000 |
| Perioperative risk of surgery elevated, n (%) | 347 (86.8) | 57 (89.1) | 290 (86.3) | 0.6886 |
| Revised cardiac risk index > 1%, n (%) | 158 (39.5) | 28 (43.8) | 130 (38.7) | 0.4865 |
| Reason for surgery: cancer, n (%) | 122 (30.5) | 20 (31.3) | 102 (30.4) | 0.8831 |
| Revised Charlson comorbidity index, mean (SD) | 1.9 (2.2) | 1.9 (2.1) | 1.9 (2.3) | 0.9629 |
| Myocardial infarction, n (%) | 25 (6.3) | 1 (1.6) | 24 (7.1) | 0.1527 |
| Congestive heart failure, n (%) | 22 (5.5) | 8 (12.5) | 14 (4.2) | 0.0139 |
| Peripheral vascular disease, n (%) | 18 (4.5) | 0 (0.0) | 18 (5.4) | 0.0911 |
| Cerebrovascular disease, n (%) | 33 (8.3) | 4 (6.3) | 29 (8.6) | 0.6285 |
| Dementia, n (%) | 4 (1.0) | 0 (0.0) | 4 (1.2) | 1.0000 |
| Chronic pulmonary disease, n (%) | 60 (15.0) | 11 (17.2) | 49 (14.6) | 0.5702 |
| Rheumatologic disease, n (%) | 13 (3.3) | 4 (6.3) | 9 (2.7) | 0.1380 |
| Peptic ulcer disease, n (%) | 0 (0.0) | 0 (0.0) | 0 (0.0) | N/A |
| Mild liver disease, n (%) | 10 (2.5) | 0 (0.0) | 10 (3.0) | 0.3756 |
| Diabetes without chronic complications, n (%) | 57 (14.3) | 4 (6.3) | 53 (15.8) | 0.0505 |
| Diabetes with chronic complications, n (%) | 37 (9.3) | 6 (9.4) | 31 (9.2) | 1.0000 |
| Hemiplegia or paraplegia, n (%) | 9 (2.3) | 2 (3.1) | 7 (2.1) | 0.6407 |
| Renal disease, n (%) | 44 (11.0) | 7 (10.9) | 37 (11.0) | 1.0000 |
| Any malignancy, n (%) | 129 (32.3) | 22 (34.4) | 107 (31.9) | 0.7706 |
| Moderate or severe liver disease, n (%) | 16 (4.0) | 1 (1.6) | 15 (4.5) | 0.4859 |
| Metastatic solid tumor, n (%) | 28 (7.0) | 3 (4.7) | 25 (7.4) | 0.5954 |
| AIDS/HIV, n (%) | 6 (1.5) | 2 (3.1) | 4 (1.2) | 0.2466 |
| Functional capacity, n (%) good | 184 (46.0) | 11 (17.7) | 23 (7.0) | 0.0118 |
| Hospital events | ||||
| PC consult, n (%) | 7 (1.8) | 3 (4.7) | 4 (1.2) | 0.0849 |
| Underwent planned surgery, n (%) | 386 (96.5) | 62 (96.9) | 324 (96.4) | 1.0000 |
| Length of surgery, mean (SD)* | 2.9 (2.1) | 2.7 (1.7) | 2.9 (2.2) | 0.2396 |
| ICU stay, n (%)† | 56 (14.1) | 13 (20.3) | 43 (12.9) | 0.1199 |
| Postop complications | ||||
| Yes vs. none | 54 (13.6) | 12 (18.8) | 42 (12.6) | 0.2303 |
| Death, n (%) | 3 (0.8) | 1 (1.6) | 2 (0.6) | 0.4081 |
| Length of stay, mean (SD)‡ | 4.3 (5.8) | 4.5 (3.9) | 4.3 (6.2) | 0.7445 |
| Location of discharge, n (%) | 0.0002 | |||
| Home | 342 (87.69) | 44 (71.0) | 298 (90.9) | |
| Rehab | 41 (10.5) | 16 (25.8) | 25 (7.6) | |
| Other | 7 (1.8) | 2 (3.2) | 5 (1.5) | |
| Functional status on discharge, ambulatory n (%) | 356 (91.3) | 51 (82.3) | 305 (93.0) | 0.0118 |
*Length of surgery was calculated in hours from anesthesia records
†Patients who required any length of ICU stay
‡Length of stay was days spent in hospital