Advance care planning (ACP) is not used as much as it should be in patients receiving allogeneic hematopoietic cell transplantation (allo-HCT), researchers concluded after conducting a retrospective review involving 422 individuals. Participants received allo-HCT at a single center between 2008 and 2015 and subsequently died. Investigators looked how advance directives or lack thereof impacted ICU care, mechanical ventilation use, and location of death. Among the results:

• 44% of patients had advance directives prior to death.
• 7 in every 10 directives expressed a desire to forego life-prolonging treatment if terminally ill.
• ~Half of white patients had advance directives, vs 22% of Hispanic and 35% of Asian patients.
• 41% of patients with advance directives were admitted to the ICU, vs 52% of those without directives.
• Mechanical ventilation was used by 21% and 37% of patients, respectively.
• Patients with advance directives were more likely to die at home or in the hospital, rather than the ICU.