Informed consent for thrombolytic therapy for patients with acute ischemic stroke treated in routine clinical practice

Stroke; a Journal of Cerebral Circulation
Julie R RosenbaumTerri R Fried

Abstract

Little is known about informed consent for tissue plasminogen activator (tPA). Our objectives were to determine how frequently informed consent is obtained when tPA is given to stroke patients in clinical practice and whether the person providing consent (patient or surrogate) was the appropriate decision-maker. This retrospective cohort included acute stroke patients given tPA in 10 Connecticut hospitals (1996-1998). Consent was defined as any documentation of discussion about risks and benefits of tPA. Patients had adequate decision-making capacity if they were alert, oriented, and without aphasia or neglect (patient was appropriate decision-maker). Patients with any of these deficits were considered to have diminished capacity (surrogate was appropriate decision-maker). Among 63 patients who received tPA, 53 (84%) had informed consent documented; 16/53 (30%) gave their own consent. Among patients with adequate decision-making capacity, 5/8 (63%) had consent by surrogate. Among patients with diminished capacity, 7/38 (18%) provided their own consent. A substantial percentage of patients who received tPA for stroke had no consent documented. Surrogates often provided consent when the patients had capacity; conversely, patients...Continue Reading

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Citations

Feb 24, 2006·Cerebrovascular Diseases·Ingrid KaneUNKNOWN IST-3 Collaborative Group
Feb 21, 2013·Cardiology in Review·Ryan Abbott, Michael Cohen
Dec 22, 2010·Neurologic Clinics·Teresa Lim, Deborah B Marin
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Jul 6, 2010·Patient Education and Counseling·Lilisbeth Perestelo-PerezPedro Serrano-Aguilar
May 27, 2006·Stroke; a Journal of Cerebral Circulation·Michael I Weintraub
Mar 2, 2005·Stroke; a Journal of Cerebral Circulation·Chandrasekaran SivakumarAlastair M Buchan
Jan 5, 2018·Neurology·Jennifer J Majersik, Lewis B Morgenstern
Jan 5, 2018·Neurology·Scott J MendelsonShyam Prabhakaran
Jan 30, 2016·Worldviews on Evidence-based Nursing·Yinghui JinHongcai Shang
Oct 16, 2019·BMC Medical Ethics·Monica SabauDelia Mirela Tit
Dec 22, 2020·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Hanzhang XuYing Xian
Nov 3, 2021·Acta Neurologica Scandinavica·Peter AppelrosMia Svantesson

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