21.08.12
Improvement in stroke prevention surgery
Vital surgery to prevent severe stroke is taking place much more quickly following the onset of symptoms, the UK Carotid Endarterectomy Audit Report shows.
Round 4 of the report, which covers operations between 1 October 2010 and 30 September 2011, found that the median delay between the first symptoms of stroke and carotid endarterectomy was 15 days. This compares to 21 days in round 3 of the report.
NICE has set standards of 14 days for the procedure and the National Stroke Strategy recommends 48 hours from onset of symptoms. The proportion of patients treated within the NICE guidelines increased from 40% to 49% in round 4.
Carotid endarterectomy is a preventative procedure which corrects the narrowing in the internal carotid artery, reducing the risk of severe stroke. The audit analysed 5,543 cases, with participation covering 98% of trusts across the UK.
The audit also found significant variation in performance amongst hospitals, with surgery received more quickly in London than any other area. The better services offered seven day clinic access and multidisciplinary team working.
The report recommends clearly documented patient pathways, agreeing referral protocols for minor stroke and the availability of resources to deal with referrals on a daily basis, including the weekend.
Professor Ross Naylor, president of the Vascular Society and steering committee member of the UK Carotid Audit, said: “This is an excellent example of how the benefits of intervening early are being translated into routine clinical practice.
“Britain has led the drive towards expedited surgery around the world and the latest results reflect the hard work that has gone towards achieving this for our patients.”
Professor Tony Rudd, associate director of the RCP Clinical Effectiveness and Evaluation Unit (CEEU), and chair of the Intercollegiate Stroke Working Party said: “We are making steady progress towards achieving the standards set, but there are still too many patients who are being treated too slowly with unacceptable variability around the country.
“Care should be focused in centres that are well-organised and experienced in performing carotid endarterectomy surgery.”
To view the audit, visit: www.rcplondon.ac.uk/projects/uk-carotid-interventions-audit
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