Featured Research

from universities, journals, and other organizations

Patient preferences for emergency treatment of stroke examined in new study

Date:
April 22, 2014
Source:
The JAMA Network Journals
Summary:
The majority of adults surveyed in new research indicated they would want administration of clot-dissolving medications if incapacitated by a stroke, a finding that supports clinicians' use of this treatment if patient surrogates are not available to provide consent. "When an incapacitated older patient's treatment preferences are unknown and surrogate decision makers are unavailable, there are empirical grounds for presuming individual consent to thrombolysis for stroke," the authors write.

The majority of adults surveyed indicated they would want administration of clot-dissolving medications if incapacitated by a stroke, a finding that supports clinicians' use of this treatment if patient surrogates are not available to provide consent, according to a study in the April 23/30 issue of JAMA, a neurology theme issue.

"In life-threatening emergencies involving incapacitated patients without surrogates, clinicians may intervene without obtaining informed consent, applying the presumption that reasonable people would consent to treatment in such circumstances. Whether this rationale applies to the treatment of acute ischemic stroke with intravenous thrombolysis [administration of clot-busting agent] is controversial because this intervention improves functional outcomes but is not life preserving. Nonetheless, the presumption of consent to thrombolysis for ischemic stroke has recently been endorsed by professional societies," according to background information in the study.

Winston Chiong, M.D., Ph.D., of the University of California, San Francisco, and colleagues examined presumption of consent by comparing preferences for treatment of acute ischemic stroke with thrombolysis and treatment of sudden cardiac arrest with cardiopulmonary resuscitation (CPR; in which the presumption of consent is generally accepted) in a nationally representative sample of U.S. adults 50 years of age or older. The participants were randomly assigned to read 1 of 2 scenarios: in one they experienced a severe acute ischemic stroke and were brought to a hospital, and in the other they experienced an out-of-hospital cardiac arrest and were attended to by paramedics.

The stroke scenario included a graphical depiction of potential risks and benefits of treatment with thrombolysis. The cardiac arrest scenario included a similar depiction of potential outcomes after paramedic-initiated CPR. All participants were then asked whether they would want the treatment described.

The researchers found that 76.2 percent of older adults (419 of 545 participants) wanted thrombolysis for acute ischemic stroke and 75.9 percent of older adults (422 of 555 participants) wanted CPR for sudden cardiac arrest. Female sex, divorced marital status, and lower educational attainment predicted refusal of thrombolysis; poorer physical health, previous stroke, and possession of a health care advance directive predicted refusal of CPR.

"When an incapacitated older patient's treatment preferences are unknown and surrogate decision makers are unavailable, there are equally strong empirical grounds for presuming individual consent to thrombolysis for stroke as for presuming individual consent to CPR. Because the presumption of consent is generally accepted for CPR, this finding provides empirical support for policy positions recently taken by professional societies that favor the use of thrombolysis for stroke in emergency circumstances under a presumption of consent," the authors write.


Story Source:

The above story is based on materials provided by The JAMA Network Journals. Note: Materials may be edited for content and length.


Journal Reference:

  1. Winston Chiong, Anthony S. Kim, Ivy A. Huang, Nita A. Farahany, S. Andrew Josephson. Testing the Presumption of Consent to Emergency Treatment for Acute Ischemic Stroke. JAMA, 2014; 311 (16): 1689 DOI: 10.1001/jama.2014.3302

Cite This Page:

The JAMA Network Journals. "Patient preferences for emergency treatment of stroke examined in new study." ScienceDaily. ScienceDaily, 22 April 2014. <www.sciencedaily.com/releases/2014/04/140422162303.htm>.
The JAMA Network Journals. (2014, April 22). Patient preferences for emergency treatment of stroke examined in new study. ScienceDaily. Retrieved October 22, 2014 from www.sciencedaily.com/releases/2014/04/140422162303.htm
The JAMA Network Journals. "Patient preferences for emergency treatment of stroke examined in new study." ScienceDaily. www.sciencedaily.com/releases/2014/04/140422162303.htm (accessed October 22, 2014).

Share This



More Health & Medicine News

Wednesday, October 22, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Orthodontist Mom Jennifer Salzer on the Best Time for Braces

Orthodontist Mom Jennifer Salzer on the Best Time for Braces

Working Mother (Oct. 22, 2014) Is your child ready? Video provided by Working Mother
Powered by NewsLook.com
U.S. Issues Ebola Travel Restrictions, Are Visa Bans Next?

U.S. Issues Ebola Travel Restrictions, Are Visa Bans Next?

Newsy (Oct. 22, 2014) Now that the U.S. is restricting travel from West Africa, some are dropping questions about a travel ban and instead asking about visa bans. Video provided by Newsy
Powered by NewsLook.com
US to Track Everyone Coming from Ebola Nations

US to Track Everyone Coming from Ebola Nations

AP (Oct. 22, 2014) Stepping up their vigilance against Ebola, federal authorities said Wednesday that everyone traveling into the US from Ebola-stricken nations will be monitored for symptoms for 21 days. (Oct. 22) Video provided by AP
Powered by NewsLook.com
Doctors Help Paralysed Man Walk Again, Patient in Disbelief

Doctors Help Paralysed Man Walk Again, Patient in Disbelief

AFP (Oct. 22, 2014) Polish doctors describe how they helped a paralysed man walk again, with the patient in disbelief at the return of sensation to his legs. Duration: 1:04 Video provided by AFP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins