Stroke victims’ outcomes vary

Anna Ranta. PHOTO: SUPPLIED
Anna Ranta. PHOTO: SUPPLIED
Those living outside larger centres are more likely to experience worse long-term health outcomes after a stroke, University of Otago research has found.

Research from its Wellington campus found stroke patients cared for in provincial and rural areas had less functional independence after their stroke than city dwellers, a higher risk of death in the period following their stroke, and more chance of suffering further vascular events later.

Lead researcher Associate Professor Anna Ranta said people cared for outside urban centres were less likely to have access to stroke clot retrieval, a life-saving but complex and time-critical procedure.

The researchers, working on the Health Research Council-funded REGIONS Care study, found they were also less likely to have access to specialist best practice care in acute stroke care units and to high-intensity rehabilitation and post-stroke community support.

Prof Ranta said Maori and Pasifika were 15 years younger on average than other New Zealanders when they experienced a stroke, Maori patients in particular experiencing a higher risk of death 12 months after their stroke.

This is despite Maori gaining access to hospital care in a timely fashion, and with no overall difference in their access to therapies used to restore blood flow through or around blocked arteries.

"Of course, many Maori reside rurally and are thus disproportionately affected by the geographic inequities uncovered by the research."

Prof Ranta said early findings from the study suggest more Maori patients may be missing out on optimal secondary stroke prevention.

"What was shown unequivocally is that culturally appropriate support services are not being accessed consistently by Maori and Pasifika patients."

Feedback also highlighted the need for greater geographic equity of access, culturally appropriate and equitable care and better resources made available to people with stroke following hospital discharge.

The findings of the research were presented at the National Stroke Network’s conference in Wellington on Thursday.

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