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article imageStroke surgery delays mean risk of death for 500 every year

By Gemma Fox     Jul 22, 2010 in Health
Mini-stroke victims are being put at risk as they miss out on a specialist neck surgery they should have to prevent a full blown stroke taking place.
Patients who have suffered a mini-stroke and are therefore at high risk of suffering a severe full blown stroke are not getting the surgery they require to prevent this happening, an audit taken by The Royal College of Physicians and Vascular Society has found.
The surgery, known as a carotid endarterectomy, which unblocks arteries, should take place within 14 days of the symptoms of Transient Ischemic Attacks (TIA's or 'mini-stroke') but the audit found that only a third of 3,000 patients received this operation in time. The surgery can prevent one in five full-blown strokes taking place, meaning that 500 lives a year could be saved if the surgery is given in time.
The review of just over 3,000 cases found that only 1,005 patients received the surgery within the recommended time frame of 14 days. The effectiveness of the surgery reduces after this time. The review noted that the average wait for the surgery was 28 days.
Key problems highlighted in the delay of surgery were lack of GP referral, hospital staff and equipment. Part of the conclusion of audit was that if stroke services were concentrated in fewer, larger centres, it should ensure that equipment and staff were more readily available.
Delay in surgery was also found to be down to individual patients rather than the NHS as nearly a fifth of patients waited too long before asking for help.
The review of these cases also discovered that the NHS was seeing an estimated half of the patients they should be seeing.
Compared to countries such as the US and Australia surgeons in the UK carry out the lowest numbers of these surgeries per head every year. This works out as about 10 times fewer surgeries being carried out in the UK compared to the US and Australia.
While the current figures show that only about 4,500 UK patients receive this surgery each year, roughly 10,000 people would actually benefit from it.
This brought the audit team to their conclusion that 500 extra lives could be saved if this amount of surgery was given within the time scale of 14 days.
The Stroke Association's Nikki Hill said, "This audit shows that there is still a long way to go to make sure people get urgent preventative treatment that could prevent a catastrophic stroke."
The UK governments tsar on strokes, Professor Roger Boyle, said that he agreed that more did need to be done to prevent stroke and pointed out that new quality standards for stroke were set out a month ago which stressed the importance of surgery in preventing strokes. "The NHS has made progress on improving stroke services but we need to go further to achieve outcomes that compare with the best internationally." He said.
More about Stroke surgery, Tia, Royal college physicians, Vascular, NHS
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