Inside Health BBC Radio 4 19/1/16- notes on stroke stats

The ‘ 20% more likely to have a stroke at the weekend’ quote used by various politicians – seems to have come from study in PLOS 2004 – 2012 DATA

http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0131836#sec014
However ,20% is relative risk – one needs to know the absolute risk to make sense of that.

If admitted at weekend death rate at 7 days – 12.9 %
compared with weekday death rate – 11.1%
and public holidays 13.3%
There are also other factors, e.g. winter is a risk factor for death

However stroke outcomes have been rapidly improving
data from 2004 – 2012 RCP
http://www.londonscn.nhs.uk/wp-content/uploads/2015/04/dem-stroke-2901415.pdf
Huge amount of work is being done – stroke units, rapid CT scans, thrombolysis, Stroke units were developed w
RCP note that in 2002, 36% of people admitted to stroke unit
in 2014, 96% of people admitted to a stroke until

in 2008 1.8% people got thromboylsis – 2014 – 12% – in other words a huge change in management

We now have bigger centres – faster treatment and more nurses -> which decreases mortality rates
http://www.londonscn.nhs.uk/wp-content/uploads/2015/04/dem-stroke-2901415.pdf

PLOS study found association with nursing staffing ratios – why NICe not made safe staffing – but not physician ward rounds
http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1001705 in stroke units 2014

At the end of the day, these studies can only show association not causation
And stroke units do make a significant difference to life, and quality of life

http://www.cochrane.org/CD000197/STROKE_organised-inpatient-stroke-unit-care

The bottom line: improvements in stroke care have been enormous and have taken place within the current NHS contract for doctors – stroke professionals have researched, led and made the changes – and should be congratulated, not admonished.

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