UK stroke outcomes 'worst in Europe'
Stroke is the third biggest cause of death in England and Wales
Friday, 24, Aug 2007 08:13
Urgent reorganisation of the UK's stroke services is needed to stop the country from having the worst outcomes from the condition in western Europe, a report has warned today.
Stroke is the third most common cause of death in England and Wales and affects 150,000 people each year in the UK.
Differences in care between the UK and western Europe are blamed on several organisational and structural problems in the UK's stroke care systems.
Writing in the British Medical Journal (BMJ), Professor Hugh Markus at St George's, University of London, argues that there is in particular a poor focus on acute stroke care.
He claims that in many European countries, North America and Australia, effective thrombolysis services exist, and in some centres as many as 20 to 30 per cent of eligible patients receiving thrombolytic therapy.
This therapy includes giving anti-clotting drugs to patients within three hours of a stroke.
But in the UK currently under one per cent of eligible patients receive such therapy, according to Professor Markus.
As well as organisational problems, he believes there needs to be a change in the perception of stroke among both health professionals and the public, so that stroke is viewed as a condition that requires emergency action.
"In many European countries [brain scans are] performed on admission in the accident and emergency department, while in the UK many units struggle to provide it within 24 hours," Professor Markus writes.
"The response that 'it will make no difference to management' must be overcome now that we have effective treatments for acute stroke and research has shown that scanning patients immediately is the most cost effective strategy.
"Probably the most important outcome of reorganisation of services will be a general improvement in acute care of stroke," he concludes.
Joe Korner, director of communications at the Stroke Association, said the charity has been concerned about stroke care in the UK for "many years" and argued it is "unacceptable" outcomes for people who have a stroke in the UK are worse than in other countries.
"Radical improvements in stroke care are now within our reach and the government, with a new stroke strategy in development, has shown a commitment to improving the future of stroke care across the UK," he added.
"But it is vital that stroke gets the priority and investment it needs – without investment hundreds will die needlessly. Public awareness of stroke also needs to be increased so that people can recognise the warning signs of a stroke and dial 999 immediately."
In response to the BMJ report, health minister Dawn Primarolo said stroke care has "progressed rapidly" in the last ten years.
"Numbers of stroke deaths are falling, and advancing medical understanding gives every prospect for a real revolution in stroke treatment over the next few years," she added.
"Although we have more improvement to make to the numbers of people given clot-busting thrombolytic drugs, there are hospitals, such as Kings College, that are matching the best in the world."
A national stroke strategy is under consultation until mid-October.