Majority Favor Emergency Stroke Medications, Study


Majority of adults approved thrombolytic therapy or clot-dissolving medications for stroke during life-threatening emergency situations, according to a University of California, San Francisco study. The finding supports clinicians' use of medications without informed consent when patient's friends or family members are unavailable.

The immediate administration of medications can restrict the damage in stroke patients.  Thrombolytics is considered an effective medication in patients with early symptoms of ischemic stroke, provided it is given with three hours.

Researchers said that intravenous thrombolysis to treat acute ischemic stroke is deemed controversial because while the medication improves the functioning of the heart, it sometimes has negative outcomes too.

For some patients, thrombolysis can restore blood flow, resulting in prevention of further injury to the brain and disability. However, for others, the medication can cause extra bleeding damage in the brain, Daily Rx reports.

For the study, researchers compared the presumption of consent in treatment of acute ischemic stroke with thrombolysis to treatment of sudden cardiac arrest with cardiopulmonary resuscitation (CPR). Participants in the study were aged 50 years and above.

The participants were randomly assigned one of the two scenarios: severe acute ischemic stroke or cardiac arrest.

The researchers found that 76.2 percent of participants favored thrombolysis for acute ischemic stroke, while 75.9 percent of them (422 of 555 participants) approved CPR for sudden cardiac arrest.

Gender, marital status, and lower educational qualifications are the factors that played a role in the denial of thrombolysis treatment, while poorer physical health, stroke history and possession of a health care advance directive were factors that triggered the rejection of CPR.

"When an incapacitated older patient's treatment preferences are unknown and surrogate decision makers are unavailable, there are equally strong empirical grounds for presuming individual consent to thrombolysis for stroke as for presuming individual consent to CPR. Because the presumption of consent is generally accepted for CPR, this finding provides empirical support for policy positions recently taken by professional societies that favor the use of thrombolysis for stroke in emergency circumstances under a presumption of consent," the authors write in a press release.

The finding is published in the journal JAMA.

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