Canadian stroke victims aren't getting to hospital quickly enough after symptoms set in, and then aren't getting treatment at hospital fast enough, putting them at increased risk of brain damage, according to a new Canadian study.
Based on a national review of hospital records, the Canadian Stroke Network found that less than half of Canadians who've experienced more than three hours of stroke symptoms will receive a CT or MRI scan within an hour of arriving at a hospital.
The findings, gathered from more than 38,000 patients, also found that only 23 per cent of stroke patients in Canada are treated in specialized stroke units -- a dismal number in comparison to some Western countries where admittance rates generally top 50 per cent and more.
The audit, which surveyed 295 hospitals across the country, also found:
- Less than 1 per cent of stroke patients are benefiting from Telestroke, a 24/7 telephone service doctors in rural areas can access to quickly receive support from neurologists
- Only 50 per cent of stroke patients were given a swallowing screen to test for dysphagia, a swallowing disorder that occurs in more than half of stroke victims
- Only 22 per cent of hospitals provide stroke patients with secondary prevention care
- Only 37 per cent of patients who experience moderate to severe strokes are discharged to a rehabilitation facility
This data suggests physicians and hospitals are not following the best practices that have been defined by the evidence and the literature, the medical director of Toronto Rehab's Neuro Rehabilitation Program told CTV News on Thursday.
"We believe that if they were to follow what the best practices were, we would improve outcomes for Canadians," said Dr. Mark Bayley.
The study, the first of its kind in Canada, also highlighted another problem: most Canadians are not educated when it comes to stroke symptoms.
Caused by an interruption of blood supply to the brain, strokes are the leading cause of death and adult disability in Canada. However, they are generally not considered an emergency amongst Canadians, according to a neurology professor at McGill University.
"Every minute in delay in stroke treatment result in the loss of two million brain cells," Robert Cole told The Canadian Press. But two-thirds of stroke victims in Canada wait too long before admitting themselves to a hospital.
According to the study, the optimal time frame for the best chance of a full recovery is within four-and-half hours after initial stroke symptoms have set in. Within this time frame, doctors can administer a blood clot-busting drug called tPA. But doctors must know when the stroke began because after the four-and-half-hour window, the life-saving drug can actually cause bleeding that will extend the stroke.
The five signs of a stroke, according to the Heart and Stroke Foundation of Canada, are:
- Weakness: Loss of strength or sudden numbness in the face, arms or legs
- Trouble speaking: Trouble speaking or understanding speech
- Vision problems: Difficulty seeing
- Headache: Sudden severe and unusual headache
- Dizziness: Loss of balance
These warning signs can be temporary and can lead to irreversible brain damage if not treated.
