End-of-Life Care Decision-Making in Stroke Article Swipe
Lucy Gao
,
Charlie W. Zhao
,
David Y. Hwang
·
YOU?
·
· 2021
· Open Access
·
· DOI: https://doi.org/10.3389/fneur.2021.702833
YOU?
·
· 2021
· Open Access
·
· DOI: https://doi.org/10.3389/fneur.2021.702833
Stroke is one of the leading causes of death and long-term disability in the United States. Though advances in interventions have improved patient survival after stroke, prognostication of long-term functional outcomes remains challenging, thereby complicating discussions of treatment goals. Stroke patients who require intensive care unit care often do not have the capacity themselves to participate in decision making processes, a fact that further complicates potential end-of-life care discussions after the immediate post-stroke period. Establishing clear, consistent communication with surrogates through shared decision-making represents best practice, as these surrogates face decisions regarding artificial nutrition, tracheostomy, code status changes, and withdrawal or withholding of life-sustaining therapies. Throughout decision-making, clinicians must be aware of a myriad of factors affecting both provider recommendations and surrogate concerns, such as cognitive biases. While decision aids have the potential to better frame these conversations within intensive care units, aids specific to goals-of-care decisions for stroke patients are currently lacking. This mini review highlights the difficulties in decision-making for critically ill ischemic stroke and intracerebral hemorrhage patients, beginning with limitations in current validated clinical scales and clinician subjectivity in prognostication. We outline processes for identifying patient preferences when possible and make recommendations for collaborating closely with surrogate decision-makers on end-of-life care decisions.
Related Topics
Concepts
Metadata
- Type
- review
- Language
- en
- Landing Page
- https://doi.org/10.3389/fneur.2021.702833
- https://www.frontiersin.org/articles/10.3389/fneur.2021.702833/pdf
- OA Status
- gold
- Cited By
- 26
- References
- 141
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W3203787272
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W3203787272Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.3389/fneur.2021.702833Digital Object Identifier
- Title
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End-of-Life Care Decision-Making in StrokeWork title
- Type
-
reviewOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2021Year of publication
- Publication date
-
2021-09-28Full publication date if available
- Authors
-
Lucy Gao, Charlie W. Zhao, David Y. HwangList of authors in order
- Landing page
-
https://doi.org/10.3389/fneur.2021.702833Publisher landing page
- PDF URL
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https://www.frontiersin.org/articles/10.3389/fneur.2021.702833/pdfDirect link to full text PDF
- Open access
-
YesWhether a free full text is available
- OA status
-
goldOpen access status per OpenAlex
- OA URL
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https://www.frontiersin.org/articles/10.3389/fneur.2021.702833/pdfDirect OA link when available
- Concepts
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Medicine, Psychological intervention, Stroke (engine), Intensive care medicine, Intensive care, MEDLINE, Psychology, Nursing, Law, Engineering, Political science, Mechanical engineeringTop concepts (fields/topics) attached by OpenAlex
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26Total citation count in OpenAlex
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2025: 6, 2024: 8, 2023: 7, 2022: 5Per-year citation counts (last 5 years)
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141Number of works referenced by this work
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10Other works algorithmically related by OpenAlex
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