Featured Research

from universities, journals, and other organizations

Centralizing stroke services can reduce deaths, time in hospital

Date:
August 5, 2014
Source:
BMJ-British Medical Journal
Summary:
Centralizing acute stroke services can reduce mortality and length of hospital stay, according toa study. Centralizing means hospitals of differing capability work together to create a centralized system of stroke care, in which patients are taken to a small number of high volume specialist units rather than to the nearest hospital.

Centralizing acute stroke services can reduce mortality and length of hospital stay, according to a study published on thebmj.com today.

Related Articles


Stroke is a leading cause of death and disability worldwide. Each year in England an estimated 125,000 people have a stroke and 40,000 of them die.

Centralizing means hospitals of differing capability work together to create a centralized system of stroke care, in which patients are taken to a small number of high volume specialist units rather than to the nearest hospital.

Research suggests that this approach can improve the quality of care for stroke patients, but it is not known if this affects mortality and length of stay in hospital.

So a team of researchers based in two English urban areas (London and Greater Manchester) set out to investigate whether centralizing acute stroke services in these areas was linked with changes in mortality and time spent in hospital.

They used hospital episode statistics (HES) linked to national mortality data to analyze differences in mortality and length of hospital stay for stroke over 250,000 patients before and after centralization in London and Greater Manchester, compared with changes in the rest of England during the same period.

Level of risk was adjusted for using several factors that could have affected the results.

During the 2008-2012 study period, mortality and length of hospital stay fell in Greater Manchester, London, and the rest of England.

However, in London there was a significant fall in mortality from any cause at 3, 30 and 90 days after admission over and above that seen in the rest of England. At 90 days, the absolute reduction was -1.1, indicating 168 fewer deaths after centralization in London during the 21 month period after reconfiguration. This translates into 96 extra lives per year.

In Greater Manchester, there was no impact on mortality over and above the change seen in the rest of England.

In both areas there was also a significant reduction in length of hospital stay over and above that seen in the rest of England: 9% (-2 days) in Greater Manchester and 7% (1.4 days) in London. These figures equate to 17,685 fewer hospital days in Greater Manchester and 22,341 fewer in London since the reconfigurations, or a total annual saving of 8,842 hospital days in Greater Manchester and 12,766 in London.

Reductions in mortality and length of hospital stay were largely seen among patients with ischaemic stroke (when a blood clot blocks an artery that carries blood to the brain).

Further analyses also including 73,558 patients who lived in rural areas had little impact on the results, but the authors stress that greater travel times in rural areas "may make centralization challenging."

The authors say their findings "could also inform the centralization of other healthcare services such as cancer care, cardiovascular care, major trauma care, and vascular surgery." And they add that future research could "examine the impact of Centralizing acute stroke services on disability after stroke and also on achievement of care processes and quality of care."


Story Source:

The above story is based on materials provided by BMJ-British Medical Journal. Note: Materials may be edited for content and length.


Journal Reference:

  1. S. Morris, R. M. Hunter, A. I. G. Ramsay, R. Boaden, C. McKevitt, C. Perry, N. Pursani, A. G. Rudd, L. H. Schwamm, S. J. Turner, P. J. Tyrrell, C. D. A. Wolfe, N. J. Fulop. Impact of centralising acute stroke services in English metropolitan areas on mortality and length of hospital stay: difference-in-differences analysis. BMJ, 2014; 349 (aug04 4): g4757 DOI: 10.1136/bmj.g4757

Cite This Page:

BMJ-British Medical Journal. "Centralizing stroke services can reduce deaths, time in hospital." ScienceDaily. ScienceDaily, 5 August 2014. <www.sciencedaily.com/releases/2014/08/140805221239.htm>.
BMJ-British Medical Journal. (2014, August 5). Centralizing stroke services can reduce deaths, time in hospital. ScienceDaily. Retrieved December 19, 2014 from www.sciencedaily.com/releases/2014/08/140805221239.htm
BMJ-British Medical Journal. "Centralizing stroke services can reduce deaths, time in hospital." ScienceDaily. www.sciencedaily.com/releases/2014/08/140805221239.htm (accessed December 19, 2014).

Share This


More From ScienceDaily



More Health & Medicine News

Friday, December 19, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

The Best Tips to Curb Holiday Carbs

The Best Tips to Curb Holiday Carbs

Buzz60 (Dec. 19, 2014) It's hard to resist those delicious but fattening carbs we all crave during the winter months, but there are some ways to stay satisfied without consuming the extra calories. Vanessa Freeman (@VanessaFreeTV) has the details. Video provided by Buzz60
Powered by NewsLook.com
Sierra Leone Bikers Spread the Message to Fight Ebola

Sierra Leone Bikers Spread the Message to Fight Ebola

AFP (Dec. 19, 2014) More than 100 motorcyclists hit the road to spread awareness messages about Ebola. Nearly 7,000 people have now died from the virus, almost all of them in west Africa, according to the World Health Organization. Video provided by AFP
Powered by NewsLook.com
Researchers Test Colombian Village With High Alzheimer's Rates

Researchers Test Colombian Village With High Alzheimer's Rates

AFP (Dec. 19, 2014) In Yarumal, a village in N. Colombia, Alzheimer's has ravaged a disproportionately large number of families. A genetic "curse" that may pave the way for research on how to treat the disease that claims a new victim every four seconds. Duration: 02:42 Video provided by AFP
Powered by NewsLook.com
Double-Amputee Becomes First To Move Two Prosthetic Arms With His Mind

Double-Amputee Becomes First To Move Two Prosthetic Arms With His Mind

Buzz60 (Dec. 19, 2014) A double-amputee makes history by becoming the first person to wear and operate two prosthetic arms using only his mind. Jen Markham has the story. Video provided by Buzz60
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins