55 A Review of Stroke Demographics and Outcomes at a Regional Hospital without a Stroke Unit

Background According to the 2017 National Stroke Register Report; 75% of strokes occur in patients aged 65 years and older. Within the audit 19 stroke units reported that 70.6% of stroke patients were admitted to a stroke unit and their median length of stay of 9 days. Numerous studies have shown better outcomes in patients admitted to a stroke unit versus a medical unit leading to national stroke networks and bypass protocols for patients. However, stroke patients can still be found in non-stroke unit hospitals such as our own. Methods Demographics from HIPE data was collected on all stroke patients admitted to our hospital between January 1st and December 31st 2017. Basic statistical methods were used to analyse the data. Results We analyzed 103 patient records. The average age at presentation was 73 years (range: 35-97) and 60.1% were males. The average length of hospital stay was 16.1 days (range 1- 130 days). Ischemic (77%) events were more common than haemorrhagic events (23%). The three most common co-morbidities were hypertension (45%), hyperlipidemia (30%) and atrial fibrillation (19%). Discharge destination was home (66%), nursing home (14%), national rehabilitation (2%) and an 18% mortality rate within 3 months. The mortality rate was higher in the hemorrhagic (42%) compared to ischemic (11%). Conclusion The average length of stay was 16.1 days, considerably higher than the national stroke unit average of 9. The overall mortality rate was 5% higher than the national of 13%. Limited rehabilitation services and time awaiting national rehabilitation beds contributed to the long LOS. There is a definite need for a dedicated stroke service at our hospital, local analysis suggests that 6 beds would meet the needs of our catchment area; and this would lead to better outcomes for stroke patients. A further locally dedicated stroke audit is needed.