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Abstract Details

Pattern of Informed Consent Acquisition in Patients Undergoing Emergent Endovascular Treatment for Acute Ischemic Stroke
Ethics, Pain and Palliative Care
S17 - (-)
004
Acquisition of informed consent can be challenging in patients with acute stroke due to acute cognitive/communicative impairment and emergent availability of next-of-kin. Alternate strategies like telephone consent and two physician consents are available which are not uniformly accepted for clinical practice or recruitment into clinical trials.
We reviewed methodology of consent acquisition in a consecutive series of patients receiving endovascular treatment. We divided patients into those treated on basis of in-person consent and alternate strategies. We identified clinical and procedural differences and hospital outcomes (symptomatic intracerebral hemorrhage [ICH] and favorable outcome) differences based on consenting methodology. Favorable outcome was defined based on modified Rankin scale of 0-2 at discharge.
Of a total of 159 patients treated, 119 were treated after in person acquisition of consent: the patient in 27 and next of kin in 92 procedures. Another 40 patients were treated using alternate strategies (20 telephone consents and 20 two physician consents based on medical necessity). There was no difference in the mean ages and proportion of men among the two groups based on consenting methodology. There was a significantly greater time interval incurred between CT scan and initiation of endovascular procedure in those in whom in person consent was obtained (117卤65 minutes versus 101卤45 minutes, p=0.01). There was no difference in the total procedure time between the two groups. There was no significant difference in rates of ICH (9% versus 8%, p=0.9), or favorable outcome at discharge (28% versus 30%, p=0.8).
Consent through alternate strategies does not adversely affect procedural characteristics or patient outcome and maybe more time efficient than in-person consenting process.
Authors/Disclosures

PRESENTER 		No disclosure on file
No disclosure on file
Hamza I. Maqsood, MD (Dept of Neurology) Dr. Qureshi has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for AstraZeneca.
David Vaillancourt David Vaillancourt has received personal compensation for serving as an employee of Automated Imaging Diagnostics. David Vaillancourt has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Wiley. The institution of David Vaillancourt has received research support from NIH. David Vaillancourt has received intellectual property interests from a discovery or technology relating to health care.