Stroke patients' stay in hospital decreased



    
    Registry report shows significant gains in certain aspects of stroke care
    and highlights where more work needs to be done
    

    TORONTO, May 5 /CNW/ - From 2002 to 2005, the median length of time a
stroke patient stayed in the hospital decreased by one day, going from 7.6
days to 6.5 days, according to data from a report just released by the
Institute for Clinical Evaluative Sciences and the Registry of the Canadian
Stroke Network.
    "These data show dramatic improvements in the care of individuals with
stroke," said Michael Sharma, MD, FRCPC, Deputy Director of the Canadian
Stroke Network and Director of the Regional Stroke Program, The Ottawa
Hospital, Ottawa. "We have collectively managed to create a system which
minimizes damage and enhances recovery while reducing use of hospital
resources. This permits greater flexibility in addressing the health needs of
our population."
    The report highlights results of the 2004/2005 Ontario Stroke Audit,
which was coordinated by the Ontario Stroke Network to showcase the state of
stroke care in the province. The Audit examined acute stroke care after
implementation of the provincial government's Ontario Stroke System.

    
    Among the Ontario Stroke Audit findings:

    -   Overall, there were 23,800 hospitalizations or emergency department
        visits for acute stroke or transient ischemic attacks (TIAs or mini
        strokes) in Ontario in 2004-2005
    -   Of these, 29% of patients were referred to a secondary prevention
        clinic after discharge from the emergency department, compared to
        just 14% of patients in 2002-2003
    -   The number of operational stroke prevention clinics in Ontario
        increased from 11 in 2002-2003 to 18 in 2004-2005
    -   In 2004-2005, 14% of patients presenting within two and a half hours
        of the onset of their stroke received thrombolysis (clot-busting
        medication), compared to just 9.5% in 2002-2003.
    -   In 2004-2005, 11% of stroke patients were cared for in a dedicated
        stroke unit, compared to just 3% of stroke patients in 2002-2003.
        Clinical trials have shown that being cared for in a dedicated stroke
        unit can reduce death and disability after stroke.
    

    "Ontario has one of the best stroke care programs in Canada," says
Christina O'Callaghan, Executive Director of the Ontario Stroke Network. "This
most recent audit of acute stroke care in Ontario reveals there have been
dramatic improvements in several acute stroke care quality indicators compared
to results of a similar audit done in 2002/03. The results confirm that the
Ontario Stroke System has been successful in implementing evidence-based
practices and interventions in acute stroke care."
    The audit also highlights areas that still need improvement. Stroke
patients with moderate to severe disability, who have the longest length of
stay in hospital, should be discharged to inpatient rehabilitation following
acute hospitalization. In 2003-2004, 42% of these patients were discharged to
inpatient rehabilitation, but in 2004-2005, this decreased to 35%.
    "The fact that access to rehabilitation has decreased is worrying to me,"
says Mark Bayley, MD, Medical Director of the Neurorehabilitation Program at
the Toronto Rehabilitation Institute. "We also see that rehabilitation
programs are admitting fewer of the most severe stroke survivors. We don't
know exactly why this occurred."
    Dr. Bayley says that lack of access to rehabilitation services might turn
out to be more costly to the health care system in the long run, and negate
the money saved from improvements in acute stroke care. "Half of the people
with severe strokes who get access to rehabilitation ultimately will improve
and go home. Reduced admissions to rehabilitation means that taxpayers have to
pay for patients to live in a long-term care facility, when in fact many of
them could be home with their family."
    The cost of at-home care is much less than the cost of in-hospital care,
Dr. Bayley adds. "And of course, most patients would rather live at home."
    As Evaluation Champion for the Ontario Stroke Network, Dr. Bayley said
that its formation has encouraged all Ontarians affected by stroke to focus on
improving stroke care. "The Ontario Stroke Network is a coordinating body that
helps to advocate for and align all the efforts, to implement best practices
in stroke care. By improved coordination across the whole system, we will have
better outcomes and fewer strokes. By focusing on the care of this population,
we can show that prognosis can be improved, but at the same time, we can
spotlight areas that need to be improved. That's the overall goal. If we want
better outcomes, we are going to have to make some practice changes."

    About the Ontario Stroke Network:

    The Ontario Stroke Network provides provincial leadership and
coordination for the Ontario Stroke System. The Ontario Stroke Network vision
is "Fewer Strokes, Better Outcomes" and our Mission is "To continuously
improve stroke prevention, care, recovery, and re-integration."

    
                     Some Facts About Stroke in Ontario

    -   In Ontario, stroke is a leading cause of death (about 6% of deaths)
        and adult neurological disability
    -   About 128,000 Ontarians are living with the effects of stroke and a
        large proportion of the survivors require some form of chronic care
    -   Stroke costs the Ontario economy almost a billion dollars a year
    -   With the aging of the Ontario population, this burden can only
        increase
    -   For every 10,000 Canadian children under the age of 19, there are 6.7
        strokes
    -   After age 55, the risk of stroke doubles every 10 years
    -   A stroke survivor has a 20% chance of having another stroke within 2
        years
    -   Of every 100 people who have a stroke, 15 die (15%); 10 recover
        completely (10%); 25 recover with a minor impairment or disability
        (25%); 40 are left with a moderate to severe impairment (40%); 10 are
        so severely disabled they require long-term care (10%)

    The Warning Signs of Stroke

    Stroke can be treated. That is why it is so important to recognize and
respond to the warning signs:

    Weakness - Sudden loss of strength or sudden numbness in the face, arm,
    or leg, even if temporary

    Trouble speaking - Sudden difficulty speaking or understanding or sudden
    confusion, even if temporary

    Vision problems - Sudden trouble with vision, even if temporary

    Headache - Sudden severe and unusual headache

    Dizziness - Sudden loss of balance, especially with any of the above
    signs

    If you experience any of these symptoms, CALL 9-1-1 or your local
    emergency number immediately. For more information on stroke, visit
    www.heartandstroke.ca
    





For further information:

For further information: ontariostrokenetwork@hsf.on.ca or Chris
O'Callaghan at (416) 489-7111 x 843

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Ontario Stroke Network

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