Advance directive use among patients undergoing high-risk operations

Anthony D. Yang, David J. Bentrem, Sam G. Pappas, Elizabeth Amundsen, James E. Ward, Michael B. Ujiki, Peter Angelos

Research output: Contribution to journalArticlepeer-review

22 Scopus citations


Background The Patient Self-Determination Act requires that patients entering hospitals be asked if they have an advance directive. This has led to increased awareness of advance directives, yet surgeons have paid little attention to their use among patients undergoing even major surgery. We sought to evaluate the use of advance directives in patients undergoing pancreaticoduodenectomy and esophagectomy. Methods Patients undergoing these operations between 1996 and 2001 at a university teaching hospital were identified and reviewed for statement of advance directive, its presence in the chart, and impact on patient care. Results A total of 252 patients met inclusion criteria. The number of patients with an advance directive increased, but had little impact on patient care. Conclusions More patients having major surgery have advance directives, but the number present in the medical record remains low. Further attention to advance directives would foster increased communication between surgeons and patients and extend patient autonomy.

Original languageEnglish (US)
Pages (from-to)98-101
Number of pages4
JournalAmerican Journal of Surgery
Issue number1
StatePublished - Jul 2004
Externally publishedYes


  • Advance directive
  • Informed consent
  • Oncologic surgery

ASJC Scopus subject areas

  • Surgery


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