Urgent need for stroke units, says expert

Ireland lags behind the rest of Europe in the organised care of stroke patients and urgently needs more dedicated units to help patients survive and improve their quality of life, writes Claire O'Connell.

That's according to a leading expert who will visit Dublin this week.

Stroke patients fare better if they receive care from an organised team of specialists in a dedicated unit than if they are on a general ward, said Prof Peter Langhorne, an editor with the Cochrane Stroke Group.

Its latest systematic review of studies involving almost 7,000 patients showed that stroke patients who were seen at in-patient stroke units were more likely to be alive and living independently at home a year later.

The review, built up over 15 years, has influenced stroke services across Europe and in Australia, said Prof Langhorne, who is professor of stroke care at the University of Glasgow.

Around 90 per cent of hospitals in England and Scotland now have dedicated stroke units.

But he noted that Ireland falls far short of this mark. The National Audit of Stroke Care found that only one public hospital out of 37 had a stroke unit, less than 3 per cent, although many hospitals had plans to improve services for the approximately 10,000 people in the State who suffer a stroke each year.

Prof Langhorne, who will address a Cochrane conference at Dublin City University's school of nursing on Thursday, told The Irish Times he believed Ireland needed more stroke units and welcomes any moves in that direction.

He noted that the organised approach can probably save more lives than drug therapies, which have limited scope for stroke, whereas everyone benefits from organised care.

"It's probably about doing a whole series of simple things well. For instance, getting the diagnosis right for a start. And about half of stroke patients will have problems with their swallowing so there's a risk of inhaling food and fluids," he said.

"You want a skilled person to identify that problem if it's there and give alternatives like a drip or a nasogastric tube. That's one simple thing that has probably prevented hundreds of chest infections," he said.

"Nature is very good at helping us recover but you need to remove all the barriers that are stopping a good recovery."

In addition to improving direct patient care, dedicated stroke units also provide a focus for other activities, such as education and patient carer groups, added Prof Langhorne.

"Once you have got the organisation in place all sorts of other things spin off. It gives you a focus to move things forward as well as being a good thing in its own right."