People 'dying unnecessarily' of stroke

[Posted: Wed 09/04/2008 by Deborah Condon]

Every year in Ireland, around 10,000 people suffer a stroke and 2,500 die as a result, yet just one Irish hospital out of 37 has a fully resourced stroke unit, the Irish Heart Foundation (IHF) has said.

It has just published the results of the country’s first national stroke audit. According to the findings, up to 500 lives could be saved every year if stroke units were introduced to Irish hospitals.

The audit exposes ‘gross deficiencies’ in services provided to stroke patients and states that at best, vital services are either ad hoc or non-existent.

“This report proves what we in the medical profession felt to be true – that people are dying unnecessarily from stroke because they cannot access optimal treatment in time. We know that services for stroke victims are largely ineffective but we now have statistics to prove it and the truth is frightening”, said IHF medical director, Dr Brian Maurer.

He pointed out that if a person has a stroke tomorrow, the quality of care that they can expect to receive will be determined by ‘chance, location and a haphazard combination of circumstances’.

“Stroke units are virtually non-existent and only a tiny fraction of people are assessed for suitability to receive potentially life saving interventions, such as thrombolysis. Worse still, acute rehabilitation is only available to one in four patients, which is why so many survivors of stroke are left with avoidable and unduly prolonged disability”, Dr Maurer explained.

The audit revealed a number of shocking statistics, including:
-Just 5% of patients are admitted to hospital within two hours of stroke onset. After two hours, a patient’s chance of recovering with little or no disability is greatly reduced.
-There are just 12 stroke beds nationwide. This means that for every 33 stroke patients who need a bed, there is just one available.
-30% of hospitals do not have routine access to CT scanning within 48 hours of a stroke.
-The provision of thrombolysis – treatment that breaks up abnormal blood clots – is almost non-existent at 1%.
-Just 43% of patients are assessed by a physiotherapist within 72 hours of hospital admission.
-Access to rehabilitation for young stroke patients is limited – only five hospitals accept patients under the age of 65 to their rehabilitation units.

The audit also noted that carers receive little or no information on what to expect when a patient returns home. Furthermore, one in 10 carers could be classified as being at risk of health problems themselves.

The IHF said that it hoped the audit’s findings would act as a major ‘wake up call’ to the Government on the need to develop a stroke strategy and to roll out stroke units nationwide.

“At least 500 lives could be saved each year if stroke unit care was introduced. In the past 40 years, we have seen great improvements in services for coronary heart disease, with coronary care units established successfully and nationally. We need to apply the same sense of urgency to stroke and take a similar approach”, Dr Maurer added.

Responding to the publication of the audit, Health Minister, Mary Harney, said that she established the Cardiovascular Strategy Policy Review Group last year to advise on how to prevent the occurrence of heart disease and stroke and improve services for those affected.

“This audit has highlighted a number of areas where clinical care and the organisation of stroke services can be enhanced. I am aware that the Policy Review Group has, in the course of its work, considered the audit and will be making recommendations to me in the summer”, Minister Harney said.

She added that her department had already met with the HSE to discuss the issues raised in the audit and insisted that the HSE ‘is already working to enhance the provision of acute hospital services to stroke patients’.

The IHF National Audit of Stroke Care was carried out in association with the Department of Health by a consortium led by Prof Hannah McGee of the Royal College of Surgeons in Ireland and Prof Des O’Neill of Trinity College Dublin.

The IHF has recommended that an audit should be repeated every three years, in order to monitor developments in stroke care.

For more information on stroke, see…http://www.irishhealth.com/index.html?level=4&id=11

Anonymous   Posted: 14/04/2008 14:34

It's not just wit stroke but with many conditions, treatment depends on where you are located.

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