{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T02:20:05Z","timestamp":1775787605185,"version":"3.50.1"},"reference-count":41,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2022,5,31]],"date-time":"2022-05-31T00:00:00Z","timestamp":1653955200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Older frail patients are more likely to have timely goals of care (GOC) documentation than non\u2010frail patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To investigate whether timely documentation of GOC within 72 h differed in the context of the COVID\u201019 pandemic (2020), compared with the pre\u2010COVID\u201019 era (2019) for older frail patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Multi\u2010site retrospective cohort study was conducted in two public hospitals where all consecutive frail adult patients aged \u226565\u2009years were admitted under medical units for at least 24 h between 1 March 31 and October in 2019 and between 1 March and 31 October 2020 were included. The GOC was derived from electronic records. Frailty status was derived from hospital coding data using hospital frailty risk score (frail \u22655). The primary outcome was the documentation of GOC within 72 h of hospital admission. Secondary outcomes included hospital mortality, rapid response call, intensive care unit admission, prolonged hospital length of stay (\u226510\u2009days) and time to the documentation of GOC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The study population comprised 2021 frail patients admitted in 2019 and 1849 admitted in 2020, aged 81.2 and 90.9\u2009years respectively. The proportion of patients with timely GOC was lower in 2020, than 2019 (48.3% (893\/1849) vs 54.9% (1109\/2021); <jats:italic>P<\/jats:italic> =\u20090.021). After adjusting for confounding factors, patients in 2020 were less likely to receive timely GOC (odds ratio\u00a0=\u00a00.77; 95% confidence interval (CI) 0.68\u20130.88). Overall time to GOC documentation was longer in 2020 (hazard ratio\u00a0=\u00a00.86; 95% CI 0.80\u20130.93).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Timely GOC documentation occurred less frequently in frail patients during the COVID\u201019 pandemic than in the pre\u2010COVID\u201019 era.<\/jats:p><\/jats:sec>","DOI":"10.1111\/imj.15671","type":"journal-article","created":{"date-parts":[[2021,12,22]],"date-time":"2021-12-22T08:32:35Z","timestamp":1640161955000},"page":"935-943","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Timely goals of care documentation in patients with frailty in the <scp>COVID\u201019<\/scp> era: a retrospective multi\u2010site study"],"prefix":"10.1111","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8292-7357","authenticated-orcid":false,"given":"Ashwin","family":"Subramaniam","sequence":"first","affiliation":[{"name":"Department of Intensive Care Peninsula Health  Melbourne Victoria Australia"},{"name":"Peninsula Clinical School Monash University  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8939-7985","authenticated-orcid":false,"given":"David","family":"Pilcher","sequence":"additional","affiliation":[{"name":"Australian and New Zealand Intensive Care Research Centre, Department of Epidemiology and Preventive Medicine Monash University  Melbourne Victoria Australia"},{"name":"Department of Intensive Care Alfred Hospital  Melbourne Victoria Australia"},{"name":"Centre for Outcome and Resource Evaluation Australian and New Zealand Intensive Care Society  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3800-902X","authenticated-orcid":false,"given":"Ravindranath","family":"Tiruvoipati","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Peninsula Health  Melbourne Victoria Australia"},{"name":"Peninsula Clinical School Monash University  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Wilson","sequence":"additional","affiliation":[{"name":"Department of Information Technology Peninsula Health  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hayden","family":"Mitchell","sequence":"additional","affiliation":[{"name":"Department of Medicine Peninsula Health  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dan","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Medicine Peninsula Health  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Bailey","sequence":"additional","affiliation":[{"name":"Australian and New Zealand Intensive Care Research Centre, Department of Epidemiology and Preventive Medicine Monash University  Melbourne Victoria Australia"},{"name":"Centre for Outcome and Resource Evaluation Australian and New Zealand Intensive Care Society  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,5,31]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2020.08.014"},{"key":"e_1_2_7_3_1","unstructured":"End of Life Care in Frailty: Advance Care Planning: Clinical Guidelines.2020[cited 2021 Apr 29]. 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