Influence of Decision‐Makers' Perceived Risk on the Propensity for Intravenous Thrombolysis in Acute Ischemic Stroke: A Cross‐Sectional Study

AIMS: This study investigates the degree of the perceived risk of intravenous thrombolysis in acute cerebral infarction among surrogate decision-makers and the factors influencing their propensity to make decisions about thrombolysis. DESIGN: An investigation was conducted on a cross-sectional basis. METHODS: We recruited participants using a purposive sampling technique. All participants were recruited from the Advanced Stroke Centre in a tertiary care general hospital from January 2022 to December 2022. A total of 201 Surrogate Decision-Makers completed the survey. Using a self-designed questionnaire, the instrument of this survey contains three aspects of general information including risk perception level survey, propensity for thrombolysis, and consisting of 18 questions. RESULTS: Risk perception consists of three dimensions: economic risk perception, psychosocial risk perception, and physical functioning risk perception, and each dimension is scored in the range of 3-15 points. Higher scores indicate stronger risk perception. The mean risk perception score of acute ischemic stroke surrogate decision-makers was (11.26 ± 2.72). The average score of psychosocial risk perception was (10.71 ± 2.34); the score of physical function risk perception was (11.00 ± 2.37). The highest proportion of those choosing conservative treatment was 46.8%. The percentage of those willing to thrombolize was 27.4%, and those who were unsure about it was 25.9%. The degree of perceived economic risk, perceived psychosocial risk, and perceived physical function risk all had a significant negative effect on the propensity to make decisions about thrombolysis after excluding the confounding interference of different ages, education levels, and monthly per capita household income. CONCLUSION: This study found a significant effect of risk-perception of the surrogate decision-maker on treatment propensity. Healthcare professionals should pay attention to guiding surrogate decision-makers to establish correct disease perception and risk-perception through effective communication during thrombolysis communication in acute ischemic stroke to relieve their decision-making pressure, shorten decision-making time and reduce Door-to-Needle time to improve patient prognosis and increase the rate of thrombolytic therapy. PATIENT OR PUBLIC CONTRIBUTION: This study is a questionnaire survey conducted by the investigator and no patient or public participation is required. IMPACT: The risk perception of surrogate decision-makers is likely to play an essential role in the decision-making process. However, increased risk perception and prolonged thrombolysis are due to a lack of knowledge about thrombolysis among surrogate decision-makers. Generalizing the need for intravenous thrombolysis may improve the rate of thrombolysis and thus provide clinical benefit to patients.