• A Antolín, S Jiménez, M González, E Gómez, M Sánchez, and O Miró.
• Área Urgencias, Hospital Clínic, Grupo Investigación «Urgencias: procesos y patologías», Fundació Clínic, Barcelona, España. Electronic address: antolin@clinic.ub.es.
• Rev Clin Esp. 2014 Aug 1;214(6):296-302.

ObjectiveTo evaluate the characeristics of patients who provide written advance directives and their use in healthcare practice.MethodologyObservational, descriptive, retrospective study of all written advance directives registered at a university hospital between 2001-2011. The clinical-demographic characteristics of the patients at the time they provided the documents was studied, as was as the later use of the documents through an electronic medical history analysis.ResultsA total of 130 advance directive documents were registered. At the time of their provision, the average patient age was 61 years; some 64% were diagnosed with a neoplastic illness; 73% were completely independent (Barthel), and 36.4% presented no comorbidities (Charlson). The women were slightly older than the men (63 vs. 60, P=0.17), and they were more likely to provide advance directives (61.5% vs. 31.5%, P=0.01) than men; the womens' illnesses were less relevant (P=0.001), and the women presented less comorbidity (P=0.01). A total of 361 medical acts were reviewed (193 hospital admissions and 168 emergency visits). At the end of the study, 74 patients were alive (57%), 37 had died (28%), and in 19 cases (15%), their evolution was lost. Of those who died, 13 (35.1%) were functionally incapacitated in the terminal phase of their illness, and in 9 (69%), the advance directives were applied in the final phase of their illness.ConclusionsThe number of registered advance directives is low; they do not interfere in the care process, and the documents are considered in the final decisions of life.Copyright © 2013 Elsevier España, S.L. All rights reserved.

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