Better stroke care could save thousands of lives every year

An eight-month study at 21 Canadian hospitals, led by a Canadian Stroke Network and Heart and Stroke Foundation researcher, found that the majority of patients did not receive care on an acute stroke unit.

In theory, failure to provide organized in-patient stroke care could be contributing “to an increase of eight patients dead or dependent for every 100 stroke patients seen.”

“Given that 50,000 Canadians suffer stroke each year, more widespread implementation of organized stroke care could mean that up to 4,000 people a year – about eight per week – could be saved from death or spared the devastating disabilities stroke inflicts and the expensive long-term care that comes with it,” says Dr. Moira Kapral, lead author of the study to be published in the July issue of the journal Stroke.

Dr. Kapral used data collected through the Registry of the Canadian Stroke Network and examined stroke care in eight provinces. Among the findings:

• Even at hospitals with organized stroke units and teams in place, the majority of admitted patients did not receive care from these services.
• Delivery of t-PA – the clot-busting drug that can reverse the effects of stroke if administered within three hours – varied across the country and many eligible patients did not receive it.
• Warfarin (a medication to prevent blood clots) was prescribed in only 54% of patients with atrial fibrillation (a quivering in the heart’s upper chambers that can cause blood clots). In theory, this could contribute to more than five preventable strokes per year per 100 eligible patients.

“This demonstrates the need to harmonize stroke care across the country to save lives,” said Dr. Antoine Hakim, CEO and Scientific Director of the Canadian Stroke Network. “Better organized care can make a huge difference in the quality of life of stroke patients.”

Dr. Vladimir Hachinski, neurologist and Heart and Stroke Foundation spokesperson, agreed the time has come to co-ordinate efforts in prevention, care and rehabilitation in the fight against stroke. “We need to ensure that as many people as possible get the best care available, and apply what research has shown is effective to clinical practice. We know that organized stroke care leads to better health outcomes, but it’s still the exception rather than the rule.”