H C Hanger1, B Fogarty, T J Wilkinson, R Sainsbury. 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.
AIMS: To determine how elderly strokepatients 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 strokepatients and 82% of controls ranked death as preferable to severe disability. Strokepatients 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.
Authors: Eric E Adelman; Lynda D Lisabeth; Melinda A Smith; Jonggyu Baek; Erin C Case; Brisa N Sánchez; James F Burke; Lesli E Skolarus; Darin B Zahuranec; William J Meurer; Devin L Brown; Kevin A Kerber; Deborah A Levine; Nelda M Garcia; Morgan S Campbell; Lewis B Morgenstern Journal: Neurohospitalist Date: 2016-10-26
Authors: Adnan I Qureshi; Saqib A Chaudhry; Bo Connelly; Emily Abott; Tariq Janjua; Stanley H Kim; Jefferson T Miley; Gustavo J Rodriguez; Guven Uzun; Masaki Watanabe Journal: Crit Care Med Date: 2013-06 Impact factor: 7.598