London, United Kingdom 2013 Poster Session Blue Cerebrovasc Dis 2013; 35 (suppl 3)1-854 651 580 Acute stroke: emergency management, stroke units and complications An audit of stroke care comparing Royal Free Hospital Stroke Unit and University College London Hospital Hyper-Acute Stroke Unit to national standards. S.J. Whittingham-Jones1, W.Y. Chris Sin2, B. Dewan3 King George Hospital, Ilford, UNITED KINGDOM1, Royal Free Hospital, London, UNITED KINGDOM2, Royal Free Hospital, London, UNITED KINGDOM3 Background: Acute stroke patients local to Royal Free Hospital should be sent to the hyper-acute stroke unit at University College London Hospital (UCLH HASU) with subsequent repatriation to Royal Free Hospital. Despite this some patients are admitted directly to Royal Free Hospital. We look at the reasons for this and compare the care of acute stroke patients at these hospitals. Methods: We studied all acute stroke admissions to UCLH HASU and Royal Free Stroke Unit between April and June 2012. Data was collected from the Stroke Improvement National Audit Programme (SINAP), Cerner IT system and patient case-notes. Six key areas were reviewed: brain imaging, swallow and nutrition assessment, timely review by stroke specialists and therapists, communication with patient and family and functional outcome. Results: We identified 7 patients admitted directly to Royal Free stroke unit and 56 attending UCLH HASU. Sixty-six per cent of Royal Free patients received brain imaging within the recommended time. Speech and language therapist assessment by 72 hours after admission was achieved in 60%. Time-ly physiotherapist review and occupational therapist review was achieved in 85.7% and 71.4% re-spectively. Patients attending HASU had a better functional outcome compared to Royal Free patients (mean Modified Rankin Score 2.97 vs. 3.57) The reasons for acute stroke patients being admitted directly to Royal Free Stroke Unit are outlined in Figure 1. Conclusions: Royal Free Stroke Unit under performed in all areas when compared to UCLH HASU and national standards. HASU had a better functional outcome and were more likely to be discharged home than ongoing care or inpatient rehabilitation. We suggest that these results are because patients attending HASU are more likely to receive throm-bolysis. This may be because they present sooner from the onset of symptoms and thus receive ap-propriate assessment and treatment sooner than at Royal Free Stroke Unit.
Karger_ESC London_2013
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