ICES/Canadian Stroke Network study finds major improvements in stroke care across the province

The Registry of the Canadian Stroke Network (RCSN) 2004/05 Ontario Stroke Audit revealed significant improvements to the use of evidence-based practices and interventions when dealing with stroke patients compared to a similar audit done in 2002/03.

The improvements come after the implementation of the provincial government’s Ontario Stroke System.

The audit found:

• There were 23,800 hospitalizations or emergency department visits for acute stroke or TIA in Ontario in 2004/05.
• The audit sample included a total of 4,913 patients (approximately 21 percent of all cases).
• In 2004/05, 17 percent of patients were referred to a secondary prevention clinic after discharge from hospital – an increase from eight percent of patients in 2002/03. This coincides with an increase in the number of operational stroke prevention clinics, from 11 such facilities in 2002/03 to 28 clinics in 2004/05.
• Clinical trials have shown that being cared for in a dedicated stroke unit can reduce patients’ risk of death and disability after stroke. In 2004/05, 32 out of 152 acute institutions had dedicated stroke units, and 10.9 percent of all stroke patients were cared for on these units—an improvement from 2.7 percent of all stroke patients in 2002/03.

“With its implementation of the Ontario Stroke System, Ontario has been a national and international leader in organized stroke care delivery, and it is gratifying to see the marked improvements in stroke care across the province. However, there are still some areas where care can be improved, and regional differences are still evident,” says lead researcher Dr. Moira Kapral. Stroke is the fourth leading cause of death and a leading cause of adult disability in Canada.

Author affiliations: ICES (Dr. Kapral, Dr. Hall, Richards, Robertson, Dr. Fang); University of Toronto (Dr. Kapral, Dr. Silver); University Health Network and Mount Sinai Hospital(Dr. Kapral, Dr. Silver); University Health Network Women’s Health Program (Dr. Kapral); Ontario Stroke Network (Dr. Hall); Toronto West Stroke Network (Dr. Silver) and Canadian Stroke Network (Robertson, Dr. Kapral, Dr. Silver and Dr. Lindsay).

The study “Registry of the Canadian Stroke Network: Report on the 2004/05 Ontario Stroke Audit" is an ICES investigative report and will be published February 27, 2009.

ICES is an independent, non-profit organization that uses population-based health information to produce knowledge on a broad range of healthcare issues. Our unbiased evidence provides measures of health system performance, a clearer understanding of the shifting healthcare needs of Ontarians, and a stimulus for discussion of practical solutions to optimize scarce resources. ICES knowledge is highly regarded in Canada and abroad, and is widely used by government, hospitals, planners, and practitioners to make decisions about care delivery and to develop policy.

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