DOCUMENTATION OF LIFE-SUSTAINING TREATMENT PREFERENCES IN A NATIONAL COHORT OF VETERAN DECEDENTS
2024

Veterans' Preferences for Life-Sustaining Treatment

Sample size: 23591 publication Evidence: moderate

Author Information

Author(s): Makaroun Lena, Li Yaming, Mor Maria, Morris Stephen, Rosland Ann-Marie, Rosen Tony, Kutney-Lee Ann, Thorpe Carolyn

Primary Institution: VA Pittsburgh Healthcare System

Hypothesis

What factors are associated with the completion of life-sustaining treatment documentation among veterans?

Conclusion

Life-sustaining treatment documentation is often completed close to death and is influenced by prior healthcare utilization.

Supporting Evidence

  • 28% of veterans completed a life-sustaining treatment document.
  • LST documentation occurred a median of 142 days before death.
  • 34% of LSTs were completed by a surrogate.
  • Older age, higher comorbidity, and frailty were associated with LST completion.
  • Being unmarried and having a child as next of kin were associated with LST completion among veterans without inpatient stays.

Takeaway

This study looked at how many veterans filled out their treatment preferences before they died, and found that those who used more healthcare services were more likely to do so.

Methodology

Retrospective cohort study using VHA EHR and Medicare claims data with multivariable logistic regression.

Limitations

The study may not fully capture preferences in outpatient settings.

Participant Demographics

Veterans aged ≥65 years who died in 2021.

Statistical Information

P-Value

<0.001

Statistical Significance

p<0.001

Digital Object Identifier (DOI)

10.1093/geroni/igae098.1895

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