Advance care planning (ACP) is recommended for older patients undergoing surgery.

ACP consists of creating advance directives (ADs), identifying surrogate decision makers (SDMs), and documenting goals of care.

We identified factors associated with documentation of preoperative ACP to identify opportunities to optimize ACP for older surgical patients.

This was a retrospective study of surgical patients ≥70 years old who underwent elective, high-risk abdominal procedures between 01/2015-08/2019.

Clinical data were obtained from our institution’s National Surgical Quality Improvement Project database. ACP metrics were extracted from the electronic medical record.

We analyzed the data to identify patient factors associated with ACP metrics. We also analyzed whether ACP was more frequent for patients who experienced postoperative complications or death.