Lack of Documented Discussion of Patient and Family Preferences After Stroke

Clinicians have an obligation to discuss and document patient preferences for life-sustaining interventions in patients who present with high-mortality conditions such as ischemic stroke (which is associated with a 30-day mortality of about 14% among U.S. Medicare patients). To determine the frequency of such discussions in patients with acute ischemic stroke, researchers reviewed hospital records of a cohort of 198 patients who died within 30 days after acute ischemic stroke in California in 2007.

About half the patients died in the hospital during the 30-day poststroke period. Discussions of patient preferences regarding limitations on cardiopulmonary resuscitation, mechanical ventilation, nasogastric tube feeding, and percutaneous tube fe…