Otago Daily Times

Stroke vic­tims’ out­comes vary

- STAFF REPORTER Health · Mental Health · Medicine · Society · Health Conditions · University of Otago · Otago Region · Wellington, New Zealand

THOSE liv­ing outside larger cen­tres are more likely to ex­pe­ri­ence worse long­term 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 life­sav­ing but com­plex and time­crit­i­cal pro­ce­dure.

The re­searchers, work­ing on the Health Re­search Coun­cil­funded RE­GIONS Care study, found they were also less likely to have ac­cess to spe­cial­ist best prac­tice care in acute stroke care units and to high­in­ten­sity re­ha­bil­i­ta­tion and post­stroke 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 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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Anna Ranta

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