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Docs, Families May Underestimate Patients' Odds After Some Strokes: Study
Date:2/7/2013

e surrounding brain. The blood accumulates and compresses the surrounding brain tissue.

The study, scheduled to be presented Thursday at the American Stroke Association's annual meeting in Honolulu, estimated what outcomes might have occurred among a group of patients if they had had more aggressive care.

The researchers began by studying the records of a group of 590 patients 18 years or older who had severe intracerebral hemorrhages and were admitted to Seattle's Harborview Medical Center between 2005 and 2008.

From those patients' records, they identified factors that could be associated with the withdrawal of life support, such as age; functional status before the brain attack; degree of brain damage; size of the hemorrhage; preexisting medical conditions such as high blood pressure, diabetes and atrial fibrillation (a dangerous form of irregular heartbeat); first temperature after hospitalization; and whether the patient had a breathing tube in place for respiratory support.

The researchers then matched 78 people who were removed from life support with 78 who were not, making sure each pair shared a similar set of factors. The study found that about 38 percent of patients who had had life support withdrawn might have had an acceptable outcome if life support had continued.

Tirschwell described the study as "more of a demonstration than proof of anything in particular," noting that it does show that a positive outcome is possible in patients for whom that may not have been predicted. He also noted that for some older patients with low levels of functioning before the hemorrhagic stroke, it might not be inappropriate to withdraw life support.

"It's complex; our message only is to be cautious in predicting outcomes and don't be overly pessimistic," Tirschwell said.

Because this study was presented at a medical meeting, the data and conclusions should be viewed as preliminary until publication in a peer
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