Stroke patients arriving late to two Cork hospitals

By Seán McCárthaigh

Stroke patients admitted to two Cork hospitals face the longest delays between the onset of the condition and medical treatment.

On average, patients took seven hours to arrive at Bantry General Hospital after the onset of stroke last year, and six hours at the Mercy University Hospital, in Cork.

An analysis of 19 acute hospitals around the country revealed that 53% of patients arrived within three hours of the onset of their stroke, the desirable time window for improved medical outcome.

The 2017 National Stroke Register Report expressed concern about delays in treating stroke patients in rural areas, with arrival to eight hospitals taking over three hours, on average.

They were Bantry General Hospital; Mercy University Hospital, Cork; Portiuncula Hospital, Ballinasloe, Co Galway; Wexford General Hospital; Sligo University Hospital; University Hospital Waterford; Mayo University Hospital, Castlebar, Co Mayo, and University Hospital Galway.

Three Dublin hospitals — Beaumont, Tallaght, and St Vincent’s — all had average times of less than two hours. The average for Cork University Hospital was two hours and 17 minutes.

The 2017 National Stroke Register Report recorded data on 3,400 stroke patients discharged from acute public hospitals last year.

“There is a trend towards delayed hospital arrival in rural areas,” the report said.

“This would support the need for increased public awareness campaigns, such as the FAST [face, arms, speech, time] campaign.”

The delivery of acute treatment to stroke patients once they have arrived to hospital improved considerably last year, with 69% of patients being seen by the stroke team within three hours of admission, compared to 54% in 2016.

However, there was a wide variation between hospitals in the percentage of stroke patients getting either a CT or MRI brain scan within 45 minutes of arrival.

No stroke patient in Portiuncula Hospital, Ballinasloe, Co Galway, had a scan within 45 minutes of arrival, compared to 44% of patients in Beaumont Hospital, and 46% in Naas General Hospital. The national average was 25.4%. The rate in Bantry General Hospital was 13%, and 11% in the Mercy University Hospital. No figure for Cork University Hospital was available.

The Mercy, with a ‘door to needle’ time of 45 minutes, has the best record of all acute hospitals in giving patients timely clot-busting medication, which should be administered within 4.5 hours of the onset of ischaemic stroke (the most common form of stroke, which results from a loss of blood flow to the brain).

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