Clinical update

Stroke

According to the Stroke Association, approximately 152,000 people in the UK have a stroke each year and one in five are fatal.

Essential facts

According to the Stroke Association, approximately 152,000 people in the UK have a stroke each year and one in five are fatal. In 2010, stroke was the fourth largest cause of death after heart disease, cancer and respiratory disease. One in four strokes in the UK happen to people under the age of 65.

Picture credit: SPL

Analysis of hospital data, carried out by the Stroke Association and published in May, shows that the number of men having strokes in England aged between 40 and 54 has risen by nearly 50% in less than 15 years – from 4,260 in 2000 to 6,221 in 2014. For women over the same period, the figure has risen by almost one third – from 3,529 to 4,604. Overall, the number of strokes occurring in people of working age – from 20 to 64 – has increased by a quarter. The charity suggests the rise is linked to increasing obesity and sedentary lifestyles. Changes in hospital admission practice have also had an effect on the figures, with many more people now receiving emergency treatment.

Signs and symptoms of stroke vary but usually begin suddenly. The main symptoms include numbness and weakness in one side of the body, drooping on one side of the face, speech difficulties, vision problems, dizziness, confusion, difficulty swallowing, lack of memory and possibly loss of consciousness.

Incidence is approximately 25% higher in men than women. Risk also increases with age, family history, genetic conditions, such as sickle cell disease, and ethnicity, with people from South Asian, black African or black Caribbean at higher risk. Smoking, being overweight, lack of exercise, unhealthy diet and atrial fibrillation also increase an individual’s risk of stroke.

Nurses have a pivotal role to play in raising patients’ awareness of the risk factors for stroke, says the Stroke Association. They can advise on healthy eating, physical activity and giving up smoking, as well as encouraging people to have their blood pressure checked regularly. Nurses can also remind patients about FAST, which helps them to recognise the symptoms of stroke in the face, arms and speech, and urges people to think fast.


Expert comment

Peter Kerr, clinical nurse specialist in stroke, Western Infirmary, Glasgow

‘I’m not surprised by the results of the research. Anecdotally, in Scotland, we had a feeling that our patients were getting younger. Lifestyle is certainly one of the main reasons, but we’re also getting much better at picking up people who have had strokes. Now if there is any doubt we will send them for an MRI.

‘Get a diagnosis as soon as possible. My advice to nurses is that, if a patient fails any one of the FAST tests, send them to the specialist stroke team straightaway – don’t try to do the triage yourself.

‘We can then start to rule things in and out and get the patient treated as soon as possible.’


Find out more

Stroke Association

Different Strokes – support for younger stroke survivors

NICE guidance: Stroke rehabilitation: Long-term rehabilitation after stroke (June 2013)

NICE quality standard (June 2010)

NICE guidance: Stroke: Diagnosis and initial management of acute stroke and transient ischaemic attack (TIA) (July 2008)

Royal College of Physicians: National clinical guideline for stroke (September 2012)

This article is for subscribers only

Jobs