Audit finds progress in stroke care, but improvement needed

The number of stroke cases admitted to a stroke unit in 2022 remained unchanged at 69%, and of those admissions, 68% of the total hospital stay was spent in a stroke unit, according to the latest Irish National Audit of Stroke Report.

The audit said that both key performance indicators remain well below the national target of 90%. It has also recommended that the number of stroke unit beds should be increased so that at least 90% of patients with a stroke are cared for in a stroke unit.

Importantly, half of all patients arrived at hospital with three hours of symptom onset, 28 minutes faster than 2021.The report gives data on 90% of all stroke activity in 2022, accounting for 4,999 patients in 21 hospitals. In 2020-2021, there was a 7.1% increase in stroke admissions, followed by a 3% increase in 2022.

The key findings of the 2022 audit include:

• 47% of stroke patients were seen by a medical team within 10 minutes of hospital arrival

• 50% received a brain scan within one hour of arrival

• 89% of patients with a stroke were assessed by a health and social care professional

• The rate of swallow screening was 71%; target: 90%

• The proportion of patients admitted to a stroke unit was 69%; target: 90%

• Mortality for patients with ischaemic stroke was 7.5% and 30% for patients with haemorrhagic stroke

• The prevalence of known AF in patients admitted with stroke was 18%, with a further 10% only diagnosed after a stroke

• One-in-three patients admitted to hospital had an AF diagnosis. Two-thirds of those had a diagnosis of AF before having their stroke. Of these patients, 77% were prescribed DOACs

• 23% of AF patients on anticoagulants were either on an inadequate dose or had paused their medication or regularly forgot to take it.

Read the report at noca.ie