Quick Dips

Studying Strokes

Delays in admission to hospital and investigation are hindering recruitment of patients into trials of acute stroke management, which in turn delays the development of effective drug treatment, says Dr Ruth Bonita, principal investigator of the Auckland Stroke Study.

If stroke patients are to be included in a current study testing the effectiveness of low-dose aspirin or heparin, it is important they are admitted to hospital and given a CT scan within 48 hours of having a stroke. Bonita says trials that exclude patients who have not been admitted to hospital and investigated within 48 hours will misrepresent the majority of strokes.

She has found that 78% of all strokes in Auckland were managed inside a public hospital, but less than half of those patients received a CT scan, and only half of those received the scan within 48 hours. The main delay occurred after arriving in hospital. She says, however, that the apparent delays in hospital admissions have not had a negative impact on Aucklanders who suffer a stroke.

"The proportion who survive the first month is the same as in other similar studies where up to 85% of patients receive a CT scan," she says. "But there is plenty of room for improvement."

She adds that since there is presently no effective drug treatment available for stroke, continued effort should be directed at preventing a stroke from occurring in the first place. Even if aspirin or heparin were found to be effective, major changes in hospital admission procedures and 24-hour access to CT scans would be necessary.

The study, funded by the Health Research Council, the National Heart Foundation and the Julius Brendel Trust, also showed that there has been no overall change in the incidence of stroke since the beginning of the 1980s.