Improving the outcome of stroke

doi:10.1136/bmj.39296.711563.AD

BMJ 2007;335:359-360 (25 August), doi:10.1136/bmj.39296.711563.AD

Editorials

Improving the outcome of stroke

UK needs to reorganise services to follow the example of othercountries

The first 150 words of the full text of this article appear below.

The outcome of stroke varies markedly between countries. A studyof 12 centres in seven European countries found that mortalityvaried twofold even when adjusted for case mix and use of healthcareresources.¹ Similar variation was also found in two large internationalmulticentre trials of acute stroke.² ³ All three studies foundthe outcome was worst in the United Kingdom; in one study thedifferences in the proportion of patients dead or dependentbetween the UK and the other eight countries were between 150and 300 events per 1000 patients.²

What underlies this variation and why is outcome so poor inthe UK compared with countries with similar economies in westernEurope? Residual confounding by case mix is difficult to excludecompletely, but differences in the process of care are likelyto be important.³ In many European countries stroke care isan integral part of neurology. In contrast, in the UK . . . [Full text of this article]

Hugh Markus, professor

Centre for Clinical Neuroscience, St George's University of London, London SW17 0RE

hmarkus@sgul.ac.uk

CiteULike

Complore

Connotea

Del.icio.us Add to Digg

Digg

StumbleUpon Add to Technorati

Technorati What's this?

Relevant Articles

Getting the priorities right for stroke care: Cathie Sudlow and Charles Warlow
BMJ 2009 338: b2083. [Extract] [Full Text]

The fight for primary care: Fiona Godlee
BMJ 2007 335: 0. [Extract] [Full Text]

Apply science, not politics: David Barer
BMJ 2007 335: 464. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

Sudlow, C., Warlow, C. (2009). Getting the priorities right for stroke care. BMJ 338: b2083-b2083 [Full text]
McCarron, M O, Armstrong, M, McCarron, P (2008). Potential for quality improvement of acute stroke management in a district general hospital. Emerg. Med. J. 25: 270-273 [Abstract] [Full text]
Dudley, N., Blacktop, J. (2008). The 'hype' in hyper-acute stroke. Age Ageing 37: 236-236 [Full text]
Hughes, G. (2007). A potpourri of news. Emerg. Med. J. 24: 746-747 [Full text]
Barer, D. (2007). Apply science, not politics. BMJ 335: 464-464 [Full text]

Rapid Responses:

Read all Rapid Responses

BETTER STROKE CARE AND MORTALITY: Pazhvoor shibu, et al.
bmj.com, 27 Aug 2007 [Full text]
Management of acute stroke: Roger A Fisken
bmj.com, 27 Aug 2007 [Full text]
Stroke: full system development required: Desmond O'Neill, et al.
bmj.com, 29 Aug 2007 [Full text]
Imaging capacity must meet demand: S. Michael Crawford
bmj.com, 29 Aug 2007 [Full text]
What about TIA ?: L S Lewis
bmj.com, 29 Aug 2007 [Full text]
Variables not parameters: Neville W Goodman
bmj.com, 29 Aug 2007 [Full text]
Stroke Outcomes are also Influenced by Organised, Timely and Intensive Rehabilitation: Ruth M Kent, et al.
bmj.com, 29 Aug 2007 [Full text]
Acute Stroke Care: Science not Politics: David Barer
bmj.com, 30 Aug 2007 [Full text]
Improving the outcome of stroke: Philip L Clatworthy, et al.
bmj.com, 30 Aug 2007 [Full text]