Boost stroke care to prevent disability, save billions: report

Widespread access to stroke care clinics could prevent tens of thousands of strokes, according to an economic analysis released Wednesday by Canadian health-care groups.

Widespread access to stroke care clinics could prevent tens of thousands of strokes and save at least $8 billion in health-care costs over the next 20 years, doctors said Wednesday.

The economic analysis by the Heart and Stroke Foundation of Canada and the Canadian Stroke Network looked at preventions and treatments for strokes that aren't used routinely across the country.

The measures include:

  • Building "organized stroke care units," special stroke teams within a hospital.
  • More widespread use of clot-busting therapies.
  • Improving access to rehabilitation.

A stroke is a brain injury caused by a lack of blood.It happens to 50,000 Canadians each year.

John Anderson was only 46 when he had a major stroke eight years ago. He was taken to an Ottawahospital, where his wife Sharon asked for clot-busting therapyto limit the damage to her husband's brain, but she saidthe doctor on dutywas reluctant to administer it.

"He said, 'Mrs. Anderson, these are really powerful drugs.'Those powerful drugs could have made asignificant difference in our lives." Her husbandnow has trouble saying a short sentence.

Adopting the recommendations could prevent more than 160,000 strokes and prevent disability in 60,000 Canadians, said Dr. Mike Sharma, a neurologist and author of the report.

Ontario hospitals given clot-busting drugs

The savings projections were based on findings in Ontario, which introduced a co-ordinated stroke system in 2000.

Emergency room physicians at several hospitals around the province were provided withCT scansneeded to diagnose the type of stroke that is treatable with clot-busting drugs called tissue plasminogen activators (TPA). They were alsotrained in how to administer themedication, which needs to be given within three hours of a stroke.

"If you use thrombolytic therapy, TPA, in an acute stroke, you reduce that individual's chance of being disabled by 30 per cent," said Sharma.

The number ofstroke patients receiving clot-busting medications atspecialized regional stroke centres jumped to32 per cent, from9.9per centin2000-2001, the groups said.

But not all Canadianhospitals are equipped to deliver TPA.

"The person with suspected stroke who might be a candidate to get the clot-busting treatment needs to havea CT scan done immediately, and not all the hospitals inNova Scotiaare equipped with CT scanners," said Dr. Stephen Phillips,a stroke specialist inthat province, whichhas the worst stroke outcomes in Canada.

To be treated quickly, people also need to recognize thesesudden warnings signs:

  • Weakness, numbness or tingling in face, arms or legs, especially on one side of the body.
  • Trouble speaking or understanding speech.
  • Blurring, double vision or loss of vision.
  • Severe headache.
  • Dizziness, loss of balance.

Making thechanges at hospitals in other provinces may require a shift in thinking, Sharma said.Ambulances may need to drive further to take patientsto an emergency roomequipped with CT scanners and clot-busting drugs, rather than the closest hospital.

A national stroke strategy and regional stroke centres and could ensure that 90 per cent of Canadians would be within reach of clot-busting therapy, the report's authors said.