Preference and Values of Stroke Interventions, Kingdom of Saudi Arabia

Abstract

Background. Acute ischemic stroke (AIS) occurs when there is a sudden occlusion of the arterial blood supply to part of the brain resulting in sudden focal neurological deficits. Recent major clinical trials of reperfusion therapy had proved the efficacy of timely stroke intervention to restore blood flow. Development of acute stroke protocols waiving the informed consent to obtain necessarily brain images or provide thrombolytic therapy is important to streamline and organize efforts to achieve the goal of early intervention and better functional outcome. Objective. This study aims to identify the preference and values of acute stroke interventions standard of care therapy without informed consent in the absence of surrogate decision-makers. Methods. A cross-sectional survey was conducted in the Kingdom of Saudi Arabia using an electronic questionnaire. The questionnaire addressed the patients' preference of acute stroke protocol waiving the informed consent for hyperacute brain images and delivering thrombolytic therapy or mechanical thrombectomy in absence of surrogate. All Saudi population aging from 18 to 65 years were invited to participate. Results. The study included 2004 participants with ages ranging from 18 to 65 years with mean age of 30.1 years. About 66% of the participants were females and 95% were Saudi. Overall, 90.5% of the participants agreed on performing computed tomography angiography (CTA) by the medical staff for the acute strokes without consenting followed by 79% for thrombolytic therapy, 70.8% for mechanical thrombectomy, and only 49.3% for acute lifesaving surgical intervention. Conclusion. Researchers found that the high percentage of participants had favorable response and positive perception toward providing acute stroke intervention and mechanical thrombectomy without informed consent. However, the study showed skeptical acceptance among participants regarding invasive surgical measures.

Clinical Characteristics of Ischemic Stroke Patients <50 Years Old at a University Hospital: A Retrospective Descriptive Study

“…We found that 64.2% of the patients were female. This was comparable to the findings of a regional study in which 66.5% of study participants were female [ 14 ]. A study conducted in Riyadh, on the other hand, reported a majority of male patients (68.2%) [ 16 ].…”

“…The average age of the participants in our study was 36.65 years. This was slightly higher than the mean age of 30.1 years reported in a local study by Alamei et al [ 14 ] and lower than the mean age of 37 years reported in a study of Chinese patients [ 15 ]. This indicates that younger people are more likely to experience strokes.…”

Clinical profile and risk factors for stroke in inpatients admitted in tertiary care center, Saudi Arabia

“…The incidence of stroke, frequency of different types of risk factors, and risk factors vary in different countries (Katan and Luft, 2018). A comprehensive analysis of 56 population-based studies showed that stroke incidence has decreased by 42 percent in highincome nations, whereas it has more than quadrupled in low-income countries in recent years (Alamri et al, 2019). Stroke is developing as a main health problem in the Middle East region, with the mortality going to be doubled by 2030 (Tran et al, 2010).…”