Changes in stroke care at Auckland Hospital between 1996 and 2001.
OBJECTIVE
In 1996, we performed a descriptive audit of stroke care in Auckland Hospital. Since then, a mobile stroke team has been established. We have repeated the 1996 audit to assess changes in stroke management.


METHODS
From 1 June to 30 September 2001, information was prospectively recorded for all patients with stroke.


RESULTS
There were 177 strokes in 175 patients (92 men, mean age 70.9, standard deviation [SD] 14.9 years). Ninety-seven percent of patients had cerebral imaging (median 4.5 hours; interquartile range [IQR] 2.7-11.6). Acute aspirin was given to 78% of patients in 2001 and 40% in 1996 (p <0.001). Twenty-four percent of patients were kept 'nil by mouth' for at least 24 hours (46% in 1996, p <0.001). At discharge, 73% of patients were taking antiplatelet or anticoagulant therapy (61% in 1996, p <0.001). Only 50% of the patients with elevated discharge blood pressures were taking antihypertensives. There had been a reduction in the mean length of hospital stay to 16 days (21 days in 1996) but no significant change in mortality (14% compared with 17% in 1996).


CONCLUSIONS
A stroke service may increase the attention to the 'processes' of stroke care and use of therapies, which are shown to be of benefit in randomised controlled trials.
Barber
Alan
A
Auckland City Hospital Stroke Service and University of Auckland, Auckland, New Zealand. abarber@adhb.govt.nz
Charleston
Alison
A
Anderson
Neil
N
Spriggs
David
D
Bennett
Derek
D
Bennett
Patricia
P
Thomas
Kirsty
K
Baker
Yvette
Y
D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001241:Aspirin / Q000627:therapeutic use; D005260:Female; D006760:Hospitalization; D006786:Hospitals, Urban; D006801:Humans; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D007902:Length of Stay / Q000639:trends; D008297:Male; D008485:Medical Audit; D009026:Mortality / Q000639:trends; D009520:New Zealand / Q000453:epidemiology; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D010818:Practice Patterns, Physicians' / Q000639:trends*; D020521:Stroke / Q000401:mortality / Q000628:therapy*
D000925:Anticoagulants; D000959:Antihypertensive Agents; D000960:Hypolipidemic Agents; D010975:Platelet Aggregation Inhibitors; D001241:Aspirin