ASA: Be More Patient With Post-ICH Life Support, Study Suggests
(HealthDay News) – Some patients with intracerebral hemorrhage (ICH) whose life support is withdrawn may have achieved a less-than-ideal but acceptable recovery had they remained connected, according to a study presented at the American Heart Association's International Stroke Conference, held from Feb. 5–8 in Honolulu.
To estimate what the outcomes in a cohort of ICH patients might have been if they did not have withdrawal of life support (WOLS), David L. Tirschwell, MD, from Harborview Medical Center in Seattle, and colleagues used modeling to create a propensity score for WOLS based on factors including age, pre-ICH modified Rankin Score (mRS), ICH volume, intraventricular hemorrhage, pre-existing hypertension, diabetes and atrial fibrillation, first temperature, and intubation in a cohort of 590 ICH patients (mean age, 67 years; 42% women). Nearest neighbor matching was used to compare baseline variables and outcomes for 78 WOLS/non-WOLS pairs.
The researchers found that, in both groups, the discharge mRS varied from 3–6, and was 1.3%, 2.6%, 6.4%, and 90%, respectively, in the WOLS group and 6.4%, 32%, 24%, and 37%, respectively, in the non-WOLS group (P<0.0005). The percentage having an acceptable outcome (defined as discharge mRS ≤4) was 4% in the WOLS group and 38% in the non-WOLS group (P<0.0005).
"These results are yet another piece of evidence suggesting health care providers may be overly pessimistic in their assessments of these patients' prognoses, leading families to choose withdrawal of life support before the patient has had a chance to recover from their stroke," Tirschwell said in a statement.
Two authors disclosed financial ties to Novo Nordisk, which supported the database used in the research.