Healthcare Atlas for the Elderly, 75 yr and older Helseatlas Strokes, emergency admissions, 2013–2015 SKDE

A stroke is a serious disease and a common cause of death and disability. A stroke involves an interruption of the blood flow to an area of the brain caused either by a blood clot (cerebral infarction) or by cerebral haemorrhage. Themost common symptoms of a stroke are paralysis of one side of the face and/or the arm or leg on one side and/or speech difficulties. Most people who suffer after-effects of a stroke will have a great need for health services in the timeafter the stroke. Swift and targeted emergency treatment can reduce the degree of disability as well as mortality.

Background Results

It is important that patients who show symptoms of a stroke are taken quick- Strokes among the elderly result in just over 5,300 emergency admissions ly to hospital. It is a well-documented fact that clot-busting treatment admi- each year. There were 40% more admissions for strokes among residents nistered within 4.5 hours of the onset of symptoms helps to reduce disability. of UNN hospital referral area than in the Stavanger area. The number of admissions for strokes decreased during the period 2013–2015. It has also been documented that treatment at a stroke unit with an interdisci- plinary team reduces disability, mortality and the need for nursing home For as a whole, 42% of patients are admitted within four hours of care. Stroke unit treatment is the single most important component of the the onset of symptoms. In Stavanger hospital referral area (54%), 50% more treatment chain for stroke patients, and national guidelines recommend that patients are admitted within four hours than in in the St. Olavs area (36%). all patients with an acute stroke should be treated at a stroke unit.

Adm. Pat. Nationally, 90% of stroke patients are treated at stroke units. In Stavanger UNN 244 236 hospital referral area (99%), nearly 50% more patients are treated at stroke St. Olavs 354 344 units than in the Førde area (67%). Førde 160 154 Inner 207 201 248 238 Treat. OUS stroke 168 162 unit All 77 74 99% 179 180 a

e Innlandet 537 523 r Stavanger 99% 185 187 a

445 431 l Vestre 98% 403 412 a r

r 169 165 Nord-Trøndelag Østfold 97% 256 265 e f 100 96 e Helgeland 96% 410 427

r Oslo

l Norway 5,329 5,180 a Bergen 95% 315 334 t i

p 206 202 Møre og Romsdal 94% 250 265 s a e o Akershus 398 386 r Nordland 93% 132 142 H a

Fonna 192 187 l 93% 141 151 a Nord-Trøndelag r 306 298 r Møre og Romsdal e Sørlandet 92% 225 243 f e

478 464 r 92% 51 55 Vestre Viken Finnmark l a t

Sørlandet 279 272 i Fonna 92% 140 153 p

Østfold 296 290 s Norway 90% 3,937 4,352 ● 2013 o ■ 2014 228 220 H UNN 88% 184 208 Stavanger ♦ 2015 239 235 Helgeland 87% 73 84 Vestfold 84% 169 201 0 5 10 15 20 Telemark 83% 137 166 St. Olavs 82% 278 337 Number per 1,000 inhabitants (≥75 years old) Source: NPR/SSB Innlandet 79% 326 413 Førde 67% 88 133 Number of admissions per 1,000 population, average for 2013–2015, adjusted for gender and age. Av. number of admissions and patients per year. 0% 20% 40% 60% 80% 100% Proportion

Adm. Source: The Norwegian Stroke Register <4 h. All

Stavanger 54% 101 187 Number of patients treated at stroke units, 2014–2015, adjusted for gender and Fonna 50% 77 153 age. Av. number treated and candidates for treatment at a stroke unit per year. Møre og Romsdal 47% 124 265 Nordland 46% 66 142 Førde 46% 60 133 Telemark 45% 75 166 Comments Bergen 44% 146 334 a e

r Sørlandet 44% 107 243

a There is little variation in admissions for strokes between hospital referral

l 43% 183 427

a Oslo r r areas, which could indicate that there are no geographical differences in the e Innlandet 43% 177 413 f e

r 42% 1,832 4,352 Norway l incidence of the disease. a t i Akershus 40% 72 180 p

s 39% 163 412

o Vestre Viken

H Vestfold 39% 79 201 Despite considerable differences between hospital referral areas in the dis- Østfold 39% 102 265 tances to hospital, the proportion of patients who arrive at a hospital within Finnmark 38% 20 55 Nord-Trøndelag 37% 57 151 four hours is relatively even between areas. Helgeland 37% 31 84 UNN 37% 76 208 St. Olavs 36% 121 337 It is a national goal that at least 90% of stroke patients should be treated at stroke units. Seven out of 20 hospital referral areas fail to reach this goal. 0% 10% 20% 30% 40% 50% Proportion Some hospitals have reported fewer than 70% of the stroke cases they have Source: The Norwegian Stroke Register treated to the Norwegian Stroke Register. The results for the hospital referral Proportion of patients admitted within 4 hours of onset of symptoms, 2014–2015, adjusted for gender and age. Av. admitted within 4 hours and can- areas in question (Akershus, Bergen, Innlandet and Finnmark) must there- didates for admission per year. fore be interpreted with caution.

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