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 other countries

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

The outcome of stroke varies markedly between countries. A study of 12 centres in seven European countries found that mortality varied twofold even when adjusted for case mix and use of healthcare resources.¹ Similar variation was also found in two large international multicentre trials of acute stroke.^{2 3} All three studies found the outcome was worst in the United Kingdom; in one study the differences in the proportion of patients dead or dependent between the UK and the other eight countries were between 150 and 300 events per 1000 patients.²

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

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

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

Related Articles

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:

• 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]