Stroke patients are not treated quickly enough
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《英国医生杂志》
The NHS needs an increase of 400-500% in the number of stroke specialists to improve stroke care to acceptable standards, it has been claimed. The National Sentinel Stroke Audit 2004, published this week, found that standards of stroke care had undergone "dramatic improvement" in recent years but that huge problems remained.
The audit of all hospitals in England, Wales, and Northern Ireland found that 82% of hospitals in England had stroke units by April 2004, when the survey was done, while the proportion of hospitals that had stroke units in Northern Ireland was 85%, and in Wales 45%. The percentage in England had risen from 74% in 2001. England's national service framework for older people set a target for all hospitals to have such a unit by 2004.
While praising improvements since the last audit, the report also found examples of "lamentable care." It said:
On a typical weekday, just more than half of stroke inpatients were in a stroke unit
More than 40% of patients were not given a scan within 24 hours of admission
Only two thirds of patients were started on aspirin within 48 hours as a way of reducing mortality and disability.
Tony Rudd, chairman of the intercollegiate working party for stroke, the body behind the work, and a consultant physician at St Thomas' Hospital, London, said, "The quality of stroke care has been steadily increasing over the years, but there are still huge problems in delivery of good stroke care.
"The number of people with heart attacks is slightly greater than numbers of people admitted with stroke but just ￡1 is spent on stroke research for every ￡20 spent on heart disease and ￡50 on cancer research. We need more stroke specialists."
He estimated that each hospital with a population of 250 000 patients needed two whole time equivalent stroke specialists—that is, a 400-500% increase in such specialists.
Jon Barrick, chief executive of the Stroke Association, said that the United Kingdom has 700 cardiologists but a mere 90 stroke care specialists, despite the fact that stroke is the United Kingdom's third biggest killer.
"This report paints a very sorry picture of stroke care," said Mr Barrick. "Despite real progress over recent years, there are still unacceptable delays in diagnosis and a lack of specialist treatment."
Each year in the United Kingdom about 130 000 people have a stroke, of whom a third are likely to die.
The audit was carried out by the Royal College of Physicians between April and June 2004 and funded by the Healthcare Commission. Later this year a service will be developed by the Royal College of Physicians, the British Association of Stroke Physicians, and the Stroke Association whereby trusts can commission visits from a team of specialists to help identify solutions.(Adrian O'Dowd)
The audit of all hospitals in England, Wales, and Northern Ireland found that 82% of hospitals in England had stroke units by April 2004, when the survey was done, while the proportion of hospitals that had stroke units in Northern Ireland was 85%, and in Wales 45%. The percentage in England had risen from 74% in 2001. England's national service framework for older people set a target for all hospitals to have such a unit by 2004.
While praising improvements since the last audit, the report also found examples of "lamentable care." It said:
On a typical weekday, just more than half of stroke inpatients were in a stroke unit
More than 40% of patients were not given a scan within 24 hours of admission
Only two thirds of patients were started on aspirin within 48 hours as a way of reducing mortality and disability.
Tony Rudd, chairman of the intercollegiate working party for stroke, the body behind the work, and a consultant physician at St Thomas' Hospital, London, said, "The quality of stroke care has been steadily increasing over the years, but there are still huge problems in delivery of good stroke care.
"The number of people with heart attacks is slightly greater than numbers of people admitted with stroke but just ￡1 is spent on stroke research for every ￡20 spent on heart disease and ￡50 on cancer research. We need more stroke specialists."
He estimated that each hospital with a population of 250 000 patients needed two whole time equivalent stroke specialists—that is, a 400-500% increase in such specialists.
Jon Barrick, chief executive of the Stroke Association, said that the United Kingdom has 700 cardiologists but a mere 90 stroke care specialists, despite the fact that stroke is the United Kingdom's third biggest killer.
"This report paints a very sorry picture of stroke care," said Mr Barrick. "Despite real progress over recent years, there are still unacceptable delays in diagnosis and a lack of specialist treatment."
Each year in the United Kingdom about 130 000 people have a stroke, of whom a third are likely to die.
The audit was carried out by the Royal College of Physicians between April and June 2004 and funded by the Healthcare Commission. Later this year a service will be developed by the Royal College of Physicians, the British Association of Stroke Physicians, and the Stroke Association whereby trusts can commission visits from a team of specialists to help identify solutions.(Adrian O'Dowd)