Less than half of stroke sufferers reach hospital within three hours

Minister for Health Stephen Donnelly: Audit of stroke care 'points to the need for investment in more designated stroke unit beds'.

An audit of care given to stroke patients has found that less than half reached a hospital within a critical three-hour window for emergency treatment and has called for greater investment in stroke units and services.

The National Office of Clinical Audit (NOCA) is publishing the findings today of its first audit of stroke care received by 4,275 patients across 20 hospitals.

The average age of stroke patients was 72 years old and a quarter of the patients were aged under 65 years.

Last year, NOCA assumed responsibility for the governance of what was the national stroke register, which has been renamed the Irish National Audit of Stroke (INAS).

The findings of the first INAS audit, however, has found the proportion of stroke patients reaching hospital within a critical three-hour window has fallen since 2017.

The 2019 audit found that 49% of more than 2,200 patients arrived at hospital within three hours of stroke symptoms presenting, representing a fall from 53% in 2017.

Time is critical in the treatment of stroke, which occurs when the blood supply to part of the brain is interrupted or reduced, starving brain cells of oxygen and nutrients and causing brain cells to die.

Stroke is the third leading cause of death in Ireland and western Europe and the leading cause of severe physical disability in adults.

Save the date! Our 1st Irish National Audit of Stroke report 2019 will be launched on Wed16th December. Further details on registration for the launch webinar will be circulated in coming days. All NOCA event info is available on https://t.co/Q8BaGdyxu5 #INAS2020 #stroke pic.twitter.com/xsutTMqgiG

— National Office of Clinical Audit (@noca_irl) November 11, 2020

Fast and early intervention and medical treatment can reduce brain damage and other complications.

Last year, 72% of patients with ischaemic stroke (blocked artery) and 62% of patients with haemorrhagic stroke (blood vessel leaking or bursting) had disabilities on discharge from hospital.

The INAS audit report found that 66% of stroke patients were seen by a doctor within one hour of arrival at hospital and that 44% of CT scans were performed within one hour.

While treatment and care are improving, the report found that 71% of stroke patients were admitted to a stroke unit, which was well below the target of 90%. 

The most common reasons for non-admission were a lack of capacity or the lack of a stroke unit at the hospital.

INAS clinical lead Professor Joe Harbison said: “This audit points to the need for investment in more designated stroke unit beds to meet our key performance indicators. It also highlights the need for patients to go to hospital as soon as possible when experiencing stroke symptoms."