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Clin Rehabil. 2000 Aug;14(4):417-24.

Stroke patients' views on stroke outcomes: death versus disability.

Author information

1
Department of Health Care of the Elderly, The Princess Margaret Hospital, Christchurch, New Zealand. Carl.Hanger@Healthlinksouth.co.nz

Abstract

AIMS:

To determine how elderly stroke patients perceive different stroke outcomes, including death, relative to each other and how these views compare with those of age/sex-matched controls.

PARTICIPANTS AND SETTING:

Twenty-eight elderly patients discharged from hospital with an acute stroke causing hemiplegia. Twenty-eight age/sex-matched control patients from the same hospital who had never had a stroke or transient ischaemic attack.

METHODS:

Patients and controls were asked to rank 11 clinical scenarios of potential stroke outcomes, from the most to the least desirable outcome.

RESULTS:

There was a striking bimodal distribution for sudden painless death in both groups. Painless death was preferred to even a minor stroke disability in over one-third of elderly individuals, whilst 20% would prefer severe disability rather than painless death. Sixty-nine per cent of stroke patients and 82% of controls ranked death as preferable to severe disability. Stroke patients may be more tolerant of disability (compared to death) than their controls (39% patients and 61% controls preferred death to any disability, p = 0.11).

CONCLUSIONS:

Our results suggest that many elderly individuals would rather die than be alive and severely disabled. This may have important implications for acute stroke treatments such as thrombolysis.

PMID:
10945426
DOI:
10.1191/0269215500cr330oa
[Indexed for MEDLINE]

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