An extra 800 stroke sufferers a year are at increased risk of death and disability due to an alarming fall in patients getting clot-busting treatment on time, it has emerged.
An Irish Heart Foundation analysis of HSE data shows just 60 per cent of patients got to hospital within the crucial 4.5-hour window for thrombolysis (medicine that dissolves the clot causing the stroke) in 2020 – compared to 73 per cent six years earlier.
The Irish National Audit of Stroke 2013-2021 by the National Office of Clinical Audit (NOCA) due out tomorrow (Jan 31) is expected to confirm a further decline in 2021 – a situation the charity describes as ‘shocking and avoidable’.
Separately new research by the Irish Heart Foundation shows that fewer people recall the vital F.A.S.T. (Face, Arm, Speech, and Time) warning signs of stroke.
“We need to encourage people to learn about the signs of stroke and to act as fast as possible in calling an ambulance as the faster the presentation to ED, the better the outcomes from acute treatment,” said Professor Rónán Collins, the HSE’s National Clinical Lead for Stroke.
Prof Collins was speaking today (Jan 30) at the launch of a new Act F.A.S.T. – Minutes Matter campaign by the Irish Heart Foundation aimed at reversing the worrying trend.
“Delays in presentation undo much of the progress we have made with stroke treatments and improving outcomes and can result in extra disability or even death,” he added.
“We want people to fundamentally realise that your chances of recovery after what might be a very serious event, are better the sooner you call an ambulance and present for treatment. Delaying or ’waiting to see’, for whatever reason, often leads to regret.”
In some cases, where a patient has a stroke in their sleep or lives alone and can not raise the alarm, arrival at hospital outside the 4.5 hour timeframe is unavoidable.
The average stroke destroys around two million brain cells every minute, the condition killing 1,423 people in Ireland in 2021 and hospitalising more than 6,000.
The Irish Heart Foundation’s Director of Advocacy, Chris Macey, said both the reduction in prompt stroke treatment and the charity’s new Ipsos research on knowledge of the F.A.S.T. signs show a “low public awareness” of the need to get to hospital without delay.
The survey of more than 1,000 adults revealed that facial weakness or drooping was the most commonly recognised word in the F.A.S.T. acronym at 35 per cent – down from 41 per cent.
Slurred speech was identified by 16 per cent, down 2 per cent, arm weakness or numbness was at 14 per cent, down 4, while awareness of the most vital component, Time to call 999, stands at just 12 per cent. Only one in ten knew what all four F.A.S.T. letters stood for.
“This is both shocking and avoidable, especially when we see the reduction in people getting to hospital on time,” said Mr Macey.
“People are needlessly dying or suffering disability by stroke, which is one condition where you can have a massive say in your own outcome. Twenty years ago, having a stroke was effectively a death sentence but if we’re not getting patients into hospital on time, we are turning the clock back,” he said.
Professor Collins added that the development of the clot retrieval treatment, thrombectomy – the most effective lifesaving treatment for stroke – in addition to further improvements in stroke services planned under the National Stroke Strategy, means that the impact of timely arrival at hospital is increasing all the time.
“There have been major improvements in acute services for stroke over the last decade but if you don’t get to hospital in time, you won’t be able to avail of them. People must understand that by getting treatment as quickly as possible after stroke they can have a huge influence on their chance of survival and recovery.”