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Advance Care Planning and Decision Regret Among Stroke Surrogate Decision Makers: A Longitudinal Cohort Study

  • 0Department of Neurology, Michigan Medicine, Ann Arbor.
Neurology +

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June 9, 2025

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June 9, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

Formal written advance care plans significantly reduced decision regret for stroke surrogate decision makers. This highlights the importance of documented end-of-life wishes in reducing surrogate distress.

Area Of Science

  • Neurology
  • Geriatrics
  • Palliative Care

Background

  • Stroke significantly impacts patients and their families, necessitating complex medical decisions.
  • Surrogate decision makers often experience emotional distress, including decision regret, following these choices.
  • Advance care planning (ACP) is crucial for aligning medical interventions with patient values.

Purpose Of The Study

  • To investigate the association between advance care planning (ACP) and decision regret in surrogate decision makers for stroke patients.
  • To quantify the impact of formal ACP on surrogate decision regret within one year post-stroke.

Main Methods

  • A cohort of 317 surrogates for 255 stroke patients was enrolled.
  • Surrogates completed a validated decision regret scale at multiple time points post-stroke.
  • Multilevel mixed-effects logistic regression models were used to assess the association between ACP and decision regret, adjusting for covariates.

Main Results

  • 42% of surrogates reported having formal advance care plans.
  • Overall decision regret scores were low (mean postdischarge: 11.2).
  • Formal written advance care plans were significantly associated with lower odds of any decision regret (OR 0.46, p=0.02) after full adjustment.

Conclusions

  • Formal written advance care plans are linked to reduced decision regret among stroke surrogate decision makers.
  • Implementing and documenting ACP may mitigate surrogate distress and improve end-of-life care experiences.
  • These findings underscore the value of proactive planning in stroke care for both patients and their families.