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  1. Kelley, Carol G. PhD, RN
  2. Lipson, Amy R. PhD
  3. Daly, Barbara J. PhD, RN
  4. Douglas, Sara L. PhD, RN


Although it would be ideal that all patients have the presence of an advance directive documented in their medical chart, it is especially important in the chronically critically ill, a patient population with an in-hospital mortality rate of 40%. How has the documentation of advance directives in the medical chart of chronically critically ill patients changed from 1997 to 2003? This article describes the patient characteristics and patterns of death in chronically critically ill patients, with or without an advance directive, enrolled in 2 consecutive studies.