Advance Directives in Community Patients with Heart Failure

Heart failure (HF) confers a high risk for mortality, and assisting patients with HF in the use of advance directives — documents that convey their preferences for end-of-life care — is good practice. Ideally, their preferences should be documented before the end of life is imminent.

To examine the prevalence and predictors of advance directives in patients with HF living in Olmsted County, Minnesota, investigators enrolled 608 of 827 consecutive patients with incident or previously diagnosed HF who were seen in a hospital or clinic. Only 41% had advance directives, 90% of which appointed a surrogate decision maker. A minority of advance directives expressed preferences about resuscitation (41%), mechanical ventilation (39%), or dialysis (10…