22. European Stroke Conference 374 Management and economics Stroke awareness in Ukraine: Pilot survey study D.V. Gulyayev1, M.V. Gulyayeva2, A. Awdeyeva3, M. Piskorska4, K. Havura5 Ukrainian Anti-Stroke Association, Kiev, UKRAINA1, Ukrainian Anti-Stroke Association, Kiev, UKRAINA2, School of Public Health, National University of “Kyiv-Mohyla Academy”, Kiev, UKRAINA3, School of Public Health, National University of “Kyiv-Mohyla Academy”, Kiev, UKRAINA4, School of Public Health, National University of “Kyiv-Mohyla Academy”, Kiev, UKRAINA5 Background. Population awareness in stroke items seems to be important for effective stroke care, but this item is not studied, and educational activities for population often are not evidence-based. Methods. The structured interview was carried out in 61 adult (mainly elderly and middle-aged) per-sons attending the educational street events related to the World Stroke Day (group A) and 18 uni-versity students (group B). The script for interviewing included questions to ascertain the knowledge of stroke symptoms and risk factors, necessity of urgent medical care in case of stroke suspicion. Results. Although most of respondents (43 and 16 in groups A and B respectively) have shown un-derstanding of necessity of urgent medical care in stroke suspicion, the knowledge of stroke symp-toms was rather poor: 5, 4, 3, 2, 1 symptoms of stroke were mentioned respectively by 1, 4, 6, 19, 19 group A respondents and 0, 1, 0, 4, 3 group B respondents. In group A 16 persons have mentioned one or more inappropriate symptoms. Knowledge of 6, 5, 4, 3, 2, 1 stroke risk factors was demon-strated by 1, 4, 10, 9, 10, 15 group A respondents and 0, 2, 1, 3, 7, 2 group B respondents. Expedi-ence of calling to the ambulance service in case of suspected stroke was mentioned by 53 group A respondents and 10 group B respondents. Conclusion. Stroke awareness of surveyed persons appeared to be rather poor. As the study groups were not representative for general population, the real situation is possibly even worse. Further studying of the stroke awareness and optimal instruments for stroke education of general population, depending on different social factors, is urgently required. 484 © 2013 S. Karger AG, Basel Scientific Programme 375 Management and economics Magnetic Resonance Imaging in a North West London TIA clinic – is current practice cost ef-fective? S. Amlani1, M.J. Wright2, M. Park3, O. Geraghty4 Imperial College Hospitals NHS Trust, London, UNITED KINGDOM1, Imperial College Hos-pitals NHS Trust, London, UNITED KINGDOM2, Imperial College Hospitals NHS Trust, London, UNITED KINGDOM3, Imperial College Hospitals NHS Trust, London, UNITED KINGDOM4 Background Patients presenting with transient ischaemic attack (TIA) are at increased risk of stroke. Early neu-roimaging is a critical part of diagnosis to identify high risk patients. The most recent definition of TIA & recommendations of the American Heart Association consider magnetic resonance imaging (MRI) particularly diffusion weighted imaging (DWI) a mandatory tool in evaluating and treating patients with TIA. We evaluated whether our current use of MRI in those patients who initially had a CT brain improved sensitivity of TIA & stroke detection, and the cost effectiveness of our approach. Method A retrospective analysis of the clinic letters and scans of 310 consecutive patients referred to our TIA service over 18 months was performed. CT brain imaging was performed routinely, a subset of patients had subsequent MRI depending on senior clinician review. Scans of patients who went on to have MRI were compared with their initial CT to detect improved sensitivity in TIA diagnosis. A cost analysis was performed on the use of MRI as the first line investigation in TIA referrals. Results 289 patients were included, of which 265 (92%) had CT brain on the day of assessment; of those 160 (60%) went on to have MRI. The mean time from clinic attendance to MRI was 27 days. Posi-tive DWI findings were found in 2 of the 160 patients (1%), both of whom were scanned within 16 days. MRI added to CT results in 37 cases (23%). CT + MRI cost £42882; MRI as first line investi-gation would have cost £29386, a saving of £13495. Conclusion The interval between assessment and MRI in our service is too long in the majority of cases for DWI changes to be detected. However MRI still added to the information provided by CT in 23% of cases. Given the beneficial costs and needs for streamlining assessment, MRI imaging should be the initial imaging modality of choice, thereby reducing costs whilst improving TIA diagnosis and treat-ment.
Karger_ESC London_2013
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