{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T13:57:22Z","timestamp":1777384642409,"version":"3.51.4"},"reference-count":34,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2024,9,21]],"date-time":"2024-09-21T00:00:00Z","timestamp":1726876800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100001807","name":"Funda\u00e7\u00e3o de Amparo \u00e0 Pesquisa do Estado de S\u00e3o Paulo","doi-asserted-by":"publisher","award":["2020\/09947-4"],"award-info":[{"award-number":["2020\/09947-4"]}],"id":[{"id":"10.13039\/501100001807","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Hosp Palliat Care"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background and Purpose<\/jats:title>\n                    <jats:p>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\u2019s early implementation. This study evaluates stroke patients who died in the hospital to determine the impact of PC evaluation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective descriptive analysis of patients who died from acute ischemic stroke was conducted. The study included patients aged \u226518\u00a0years 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%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      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 (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.001), a nearly 14-fold increase in discharges to the ward, and a threefold reduction in ICU length of stay (\n                      <jats:italic>P<\/jats:italic>\n                      = 0.011).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10499091241286059","type":"journal-article","created":{"date-parts":[[2024,9,21]],"date-time":"2024-09-21T11:53:45Z","timestamp":1726919625000},"page":"981-988","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["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"],"prefix":"10.1177","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4038-3395","authenticated-orcid":false,"given":"Maiara Silva","family":"Tramonte","sequence":"first","affiliation":[{"name":"Department of Neurology, Psychology and Psychiatry, S\u00e3o Paulo State University (UNESP), Botucatu, SP, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana Claudia Pires","family":"Carvalho","sequence":"additional","affiliation":[{"name":"Department of Neurology, Psychology and Psychiatry, S\u00e3o Paulo State University (UNESP), Botucatu, SP, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriela Figueiredo","family":"Pucci","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Pittsburgh Medical Center (UPMC), Pittsburgh, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mariana Soares","family":"Pinheiro","sequence":"additional","affiliation":[{"name":"Department of Neurology, Psychology and Psychiatry, S\u00e3o Paulo State University (UNESP), Botucatu, SP, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana Elisa Vayego","family":"Fornazari","sequence":"additional","affiliation":[{"name":"Department of Neurology, Psychology and Psychiatry, S\u00e3o Paulo State University (UNESP), Botucatu, SP, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gustavo Di Lorenzo","family":"Villas Boas","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, S\u00e3o Paulo State University (UNESP), Botucatu, SP, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcos Christiano","family":"Lange","sequence":"additional","affiliation":[{"name":"Department of Neurology, Federal University of Parana (UFPR), Curitiba, PR, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcos Ferreira","family":"Minicucci","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, S\u00e3o Paulo State University (UNESP), Botucatu, SP, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rodrigo","family":"Bazan","sequence":"additional","affiliation":[{"name":"Department of Neurology, Psychology and Psychiatry, S\u00e3o Paulo State University (UNESP), Botucatu, SP, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura Cardia Gomes","family":"Lopes","sequence":"additional","affiliation":[{"name":"Department of Neurology, Psychology and Psychiatry, S\u00e3o Paulo State University (UNESP), Botucatu, SP, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2024,9,21]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/STR.0000000000000015"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)32130-X"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1804492"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2020.11.010"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000485"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1177\/1747493020909545"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.170604"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11845-015-1290-9"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjspcare-2012-000331"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1177\/1747493015620806"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1177\/1049909118787136"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2021.0614"},{"key":"e_1_3_3_14_2","volume-title":"Worldwide Hospice Palliative Care Alliance (WHPCA)","author":"Connor SR","year":"2020","unstructured":"Connor SR. 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