Palliative Care and the Self-Fulfilling Prophecy in Stroke Patients: is There Anything to Fear? A Retrospective Study of Patients Who Died During Hospitalization in a Quaternary Care Hospital

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Autor(es): dc.contributorUniversidade Estadual Paulista (UNESP)-
Autor(es): dc.contributorMedical Center (UPMC)-
Autor(es): dc.contributorUniversidade Federal do Paraná (UFPR)-
Autor(es): dc.creatorTramonte, Maiara Silva-
Autor(es): dc.creatorCarvalho, Ana Claudia Pires-
Autor(es): dc.creatorPucci, Gabriela Figueiredo-
Autor(es): dc.creatorPinheiro, Mariana Soares-
Autor(es): dc.creatorFornazari, Ana Elisa Vayego-
Autor(es): dc.creatorVillas Boas, Gustavo Di Lorenzo-
Autor(es): dc.creatorLange, Marcos Christiano-
Autor(es): dc.creatorMinicucci, Marcos Ferreira-
Autor(es): dc.creatorBazan, Rodrigo-
Autor(es): dc.creatorLopes, Laura Cardia Gomes-
Data de aceite: dc.date.accessioned2025-08-21T23:27:54Z-
Data de disponibilização: dc.date.available2025-08-21T23:27:54Z-
Data de envio: dc.date.issued2025-04-29-
Data de envio: dc.date.issued2023-12-31-
Fonte completa do material: dc.identifierhttp://dx.doi.org/10.1177/10499091241286059-
Fonte completa do material: dc.identifierhttps://hdl.handle.net/11449/306960-
Fonte: dc.identifier.urihttp://educapes.capes.gov.br/handle/11449/306960-
Descrição: dc.descriptionBackground and Purpose: Primary palliative care (PC) aims to improve the quality of life for patients with acute ischemic stroke but is often misinterpreted as withdrawal of care. The self-fulfilling prophecy withdrawal bias is feared in this context of PC’s early implementation. This study evaluates stroke patients who died in the hospital to determine the impact of PC evaluation. Methods: A retrospective descriptive analysis of patients who died from acute ischemic stroke was conducted. The study included patients aged ≥18 years admitted to the Stroke Unit of a quaternary hospital in Brazil from January 2017 to December 2018. The impact of PC assessment on outcomes was analyzed, with significance set at 5%. Results: Among the patients who died during hospitalization as a result of an ischemic stroke (n = 77), 39 (%) were assessed by the palliative care team. There was no difference in the total length of stay or duration of antibiotic therapy. Logistic regression corrected for significant variables from the univariate analysis revealed that PC evaluation was associated with a 31-fold increase in opioid use (P < 0.001), a nearly 14-fold increase in discharges to the ward, and a threefold reduction in ICU length of stay (P = 0.011). Conclusion: PC team involvement was associated with higher rates of discharge to the floors, inferring more time spent with family and increased opioid use, suggesting better symptom control, without reducing the overall length of stay or duration of antibiotic therapy. This underscores that PC does not equate to withdrawal of care.-
Descrição: dc.descriptionDepartment of Neurology Psychology and Psychiatry São Paulo State University (UNESP), SP-
Descrição: dc.descriptionDepartment of Neurology University of Pittsburgh Medical Center (UPMC)-
Descrição: dc.descriptionDepartment of Internal Medicine São Paulo State University (UNESP), SP-
Descrição: dc.descriptionDepartment of Neurology Federal University of Parana (UFPR), PR-
Descrição: dc.descriptionDepartment of Neurology Psychology and Psychiatry São Paulo State University (UNESP), SP-
Descrição: dc.descriptionDepartment of Internal Medicine São Paulo State University (UNESP), SP-
Idioma: dc.languageen-
Relação: dc.relationAmerican Journal of Hospice and Palliative Medicine-
???dc.source???: dc.sourceScopus-
Palavras-chave: dc.subjectacute ischemic stroke-
Palavras-chave: dc.subjectcerebrovascular diseases-
Palavras-chave: dc.subjectend of life-
Palavras-chave: dc.subjectischemic stroke-
Palavras-chave: dc.subjectpalliative care-
Palavras-chave: dc.subjectpalliative supportive care-
Título: dc.titlePalliative Care and the Self-Fulfilling Prophecy in Stroke Patients: is There Anything to Fear? A Retrospective Study of Patients Who Died During Hospitalization in a Quaternary Care Hospital-
Tipo de arquivo: dc.typelivro digital-
Aparece nas coleções:Repositório Institucional - Unesp

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