Display Settings:

Format

Send to:

Choose Destination
We are sorry, but NCBI web applications do not support your browser and may not function properly. More information
Neurology. 2012 Aug 28;79(9):941-4. doi: 10.1212/WNL.0b013e318266fc40.

Early stroke mortality, patient preferences, and the withdrawal of care bias.

Author information

  • 1Department of Neurology, University of Rochester Medical Center, Rochester, NY, USA. Adam_Kelly@urmc.rochester.edu

Abstract

OBJECTIVE:

Early mortality is a potential measure of the quality of care provided to hospitalized stroke patients. Whether in-hospital stroke mortality is reflective of deviations from evidence-based practices or patient/family preferences on life-sustaining measures is unclear.

METHODS:

All ischemic stroke mortalities at an academic medical center were reviewed to better understand the causes of inpatient stroke mortality.

RESULTS:

Among 37 deaths or discharges to hospice in 2009, 36 occurred after a patient/family decision to withdraw/withhold potentially life-sustaining interventions. An independent survey of 3 vascular neurologists revealed that some early deaths could have been delayed beyond 30 days if patients or families had agreed to more aggressive measures. From these data, we estimate the magnitude of a "withdrawal of care" bias to be approximately 40% of the observed short-term mortality.

CONCLUSIONS:

Acute stroke mortality may be more reflective of patient/family preferences than the provision of evidence-based care.

PMID:
22927679
[PubMed - indexed for MEDLINE]
PMCID:
PMC3425847
Free PMC Article
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Icon for HighWire Icon for PubMed Central
    Loading ...
    Write to the Help Desk