{"doi":"10.1016/j.jcrc.2013.08.024","title":"Are written advance directives helpful to guide end-of-life therapy in the intensive care unit? A retrospective matched-cohort study","abstract":null,"journal":"Journal of Critical Care","year":2014,"id":621174,"datarank":0.6646225198264971,"base_score":4.430816798843313,"endowment":4.430816798843313,"self_citation_contribution":0.6646225198264971,"citation_network_contribution":0.0,"self_endowment_contribution":0.6646225198264971,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":83,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1603839,"name":"Ilka Peschel","orcid":null,"position":1,"is_corresponding":false},{"id":1603841,"name":"Daniel Schwarzkopf","orcid":null,"position":2,"is_corresponding":false},{"id":150553,"name":"J. Randall Curtis","orcid":null,"position":3,"is_corresponding":false},{"id":1603842,"name":"Isabella Westermann","orcid":null,"position":4,"is_corresponding":false},{"id":1603844,"name":"Bjoern Kabisch","orcid":null,"position":5,"is_corresponding":false},{"id":1603845,"name":"Ruediger Pfeifer","orcid":null,"position":6,"is_corresponding":false},{"id":1603846,"name":"Albrecht Guenther","orcid":null,"position":7,"is_corresponding":false},{"id":879256,"name":"Andrej Michalsen","orcid":null,"position":8,"is_corresponding":false},{"id":45559,"name":"Konrad Reinhart","orcid":"0000-0002-2324-5444","position":9,"is_corresponding":false},{"id":847811,"name":"Christiane S. Hartog","orcid":"0000-0003-1098-9775","position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Are written advance directives helpful to guide end-of-life therapy in the intensive care unit? A retrospective matched-cohort study","abstract":"<h4>Purpose</h4>The purpose of the study was to determine whether treatment preferences in patients' advance directives (ADs) are associated with life-supporting treatments received during end-of-life care in the intensive care unit (ICU).<h4>Material and methods</h4>This is a retrospective cohort study, including patients who died in 4 ICUs of a university hospital in Germany. Patients with ADs were matched with 2 patients each without ADs using propensity scores.<h4>Results</h4>Sixty-four (13%) of 477 patients had ADs, written a median of 109 weeks before admission. Five categories of applicability conditions were identified, most of them difficult to interpret in the ICU (eg, \"advanced brain impairment\" or \"imminent death\"). Advance directives contained a number of treatment refusals. Specifically, 63 of 64 refused \"life-sustaining measures.\" Compared to patients without ADs, patients with ADs were less likely to receive cardiopulmonary resuscitation (9% vs 23%, P = .029) and more likely to have do-not-resuscitate orders (77% vs 56%, P = .007). Therapy-limiting decisions and ICU length of stay did not differ between those with or without ADs.<h4>Conclusions</h4>Patients with ADs are less likely to receive cardiopulmonary resuscitation but otherwise receive similar life-sustaining treatments compared to matched patients without ADs. More research is needed to explore reasons for potential noncompliance with patient preferences.","is_dataset_classified":null,"base_score":4.430816798843313,"endowment":4.430816798843313,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"24331948","pmcid":null,"openalex_id":"https://openalex.org/W2042160336","authors":[],"funders":[{"funder_name":"Bundesministerium für Bildung und Forschung","grant_id":"01EO1002","title":null}],"total_grants":1,"fwci":7.0238,"citation_percentile":0.96959103,"influential_citations":0,"citation_trend":[{"year":2014,"count":3},{"year":2015,"count":7},{"year":2016,"count":12},{"year":2017,"count":3},{"year":2018,"count":4},{"year":2019,"count":8},{"year":2020,"count":15},{"year":2021,"count":5},{"year":2022,"count":4},{"year":2023,"count":10},{"year":2024,"count":5},{"year":2025,"count":4},{"year":2026,"count":3}],"oa_status":"closed","license":"https://www.elsevier.com/legal/tdmrep-license","oa_locations":[{"url":"https://api.elsevier.com/content/article/PII:S0883944113003183?httpAccept=text/xml","host_type":"publisher"},{"url":"https://api.elsevier.com/content/article/PII:S0883944113003183?httpAccept=text/plain","host_type":"publisher"},{"url":"https://doi.org/10.1016/j.jcrc.2013.08.024","host_type":"journal"},{"url":"https://pubmed.ncbi.nlm.nih.gov/24331948","host_type":"repository"}],"fields_of_study":["Palliative Care and End-of-Life Issues","Healthcare Decision-Making and Restraints","Ethics and Legal Issues in Pediatric Healthcare"],"mesh_terms":["Aged","Aged, 80 and over","Female","Germany","Humans","Intensive Care Units","Life Support Care","Male","Middle Aged","Retrospective Studies","Terminal Care","Advance Directives","Cardiopulmonary Resuscitation","Advance Directive Adherence"],"keywords":["Medicine","Retrospective cohort study","Intensive care unit","End-of-life care","Cohort","Intensive care medicine","Cohort study","Unit (ring theory)","Emergency medicine","Palliative care","Nursing","Internal medicine","ICU","AD","Intensive Care","Advance Directives","End Of Life","Cpr","Patient Autonomy","Cardiopulmonary Resuscitation","Advance Directive","Sofa","Sequential Organ Failure Assessment","Lsm","Do Not Resuscitate","Dnr","Eol","Life-sustaining Measure"],"sdg_mappings":[],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-08-03T13:31:34.500380Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}