Tuesday 20 March 2018

Deaths from strokes falling but rehab care for survivors is poor

Stroke survivor Gerry Carmody with his wife Sandra at the launch of the National Stroke Audit 2015. Photo: Sam Boal/Photocall
Stroke survivor Gerry Carmody with his wife Sandra at the launch of the National Stroke Audit 2015. Photo: Sam Boal/Photocall
Eilish O'Regan

Eilish O'Regan

Death rates from stroke have fallen by a quarter but many saved feel abandoned due to inadequate services to help them regain mobility, a new report has revealed.

For those who are treated for stroke in hospital, the death rate has dropped from 19pc to 14pc since the last audit was carried out in 2008.

The report, which was carried out by the HSE and the Irish Heart Foundation (IHF), found that 8pc of stroke patients are being discharged to nursing homes compared to 15pc in 2008.

But around 7,000 people are still hospitalised with stroke annually and the "death toll of just below 2,000 makes stroke Ireland's third-biggest killer after cancer and heart disease", it warned.

The fall in stroke deaths has been linked to different factors including the fact that more have timely treatment with "clot-busting" medication known as thrombolysis. It can dissolve blood clots and restore the flow of blood to the brain.

Other factors playing a part include better treatment of risk factors such as blood pressure and cholesterol as well a drop in smoking.

However, the audit pointed out a high proportion of survivors suffer needless disability because of a lack of rehabilitation services.

And only one-third of stroke victims who are rushed to hospital are being directly admitted to a special stroke unit where there is a range of expertise in treating stroke.

The report also found there is a serious shortage of physiotherapists, occupational therapists and speech and language therapists.

The medical director of the IHF, Dr Angie Brown, said: "If therapy levels are inadequate in hospital, we know they are significantly worse in the community. There is a near-total absence of community stroke teams, fuelling a very strong sense among survivors of being saved and then abandoned by the health system at the hospital gates."

Prof Joe Harbison, of St James's Hospital in Dublin, said that while progress had been made, it could not take away from the persistent and substantial deficits in services.

"The study showed that only about half of patients are admitted to a stroke unit at any time during their hospital stay.

"Treatment in a unit is the most basic standard in the care of stroke patients and substantially improves the chances of independent recovery after stroke."

The stroke programme needs more investment to maintain progress.

Around half of stroke survivors suffer anxiety, depression or severe psychological distress but access to services to treat these side-effects is limited to just two hospitals nationally.

The report revealed that 27 hospitals treat stroke patients during the acute phase of their care.

Of these, 21 have a stroke unit, up from one stroke unit in the whole country in 2008.

The 2015 audit found 150 stroke beds nationally. However, 61pc of in-patients with a stroke at the time of the audit were being managed on a ward other than a stroke unit.

The estimated national thrombolysis rate of 11pc is comparable to international norms.

Irish Independent

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