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Study: African-Americans Live Longer After Stroke

Survival May Not Predict Quality of Care, Researchers Say

Mortality Poor Predictor of Stroke Care

While they were unable to examine the role of patient and family-member treatment decisions on outcomes, both researchers believe these decisions probably played a major role.

In a study published last year, Holloway and colleagues found that deaths occurring immediately following stroke are often due to withholding or withdrawing life-sustaining interventions.

The newly published study and others suggest that African-Americans are more likely than whites to have these life-sustaining interventions, but it is not clear if patients and family members are fully informed when they decide to have them.

In his own research, Harvard University researcher Angelo E. Volandes, MD, found that race was not an independent predictor of the use of aggressive end-of-life treatments.

He found that when patients and family members fully understood the implications of the treatment choices they were making, they were less likely to opt for aggressive life-extending treatments regardless of race.

Volandes says the fact that more whites than African-Americans in the newly published study received hospice care suggests that whites may have been more aware of different treatment options such as hospice.

Holloway says the study also illustrates the limitations of using survival as a measure of stroke care quality.

Federal policymakers are reportedly considering requiring hospitals to publish 30-day survival data on stroke patients covered by Medicare and Medicaid.

“We have to confront the possibility that the highest quality of care doesn’t always mean the longest survival,” he says.

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