Artificial nutrition and hydration in stroke at the end of life

  • Research type

    Research Study

  • Full title

    The use of artificial nutrition and hydration at the end of life in acute stroke - a feasibility study

  • IRAS ID

    223767

  • Contact name

    Helen S Jones

  • Contact email

    helensjones@doctors.org.uk

  • Sponsor organisation

    Lancashire Teaching Hospitals NHS Trust

  • Duration of Study in the UK

    0 years, 9 months, 30 days

  • Research summary

    Patients often receive artificial fluids or feeding through a drip or feeding tube when they are unable to swallow after an acute stroke – known as artificial nutrition and hydration (ANH). For patients who are dying following their stroke, decisions are made about whether to provide ANH at the end of life.

    Current evidence from cancer and dementia suggests that ANH at the end of life provides little benefit for symptom control or survival and carries burdens. The effect of ANH in patients dying following stroke are not clear. Studies have stated how many stroke patients received the treatments as part of end of life care, but not the specific decisions made, such as the route or volume of feed or fluid provided.

    More information is needed about the decisions made about ANH at the end of life for patients with acute stroke and whether this affects how many patients experience common symptoms, such as pain, breathlessness or chest secretions. This study aims to determine whether these questions can be answered from the medical records of patients who have died following a stroke, and how many patient records would provide enough information to potentially detect a meaningful difference between how often patients who did and did not receive ANH experienced symptoms.

    Patients who died following a stroke at a teaching hospital in England would be identified. Data would be collected from the medical records of their last admission regarding decisions made about ANH and symptoms they experienced. The results would be analysed to clarify whether the records could be found and if they contained relevant information. This would guide the design of a larger study with the aim of collecting enough information to establish current ANH practice at the end of life in stroke and how this affects symptoms for patients.

  • REC name

    North West - Greater Manchester West Research Ethics Committee

  • REC reference

    17/NW/0675

  • Date of REC Opinion

    8 Dec 2017

  • REC opinion

    Favourable Opinion