Irish National Audit of Stroke National Report 2022

This is the fourth INAS national report, and the tenth year of capturing stroke data in Ireland. This report provides data on 90% of all stroke activity in 2022, accounting for 4,999 patients in 21 hospitals. Stroke remains the second leading cause of death in middle- to higher-income countries, and it stands as the leading cause of acquired adult neurological disability in Ireland.

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Key Findings

Between 2020 and 2021, there was a 7.1% increase in stroke admissions, followed by a 3.0% increase in 2022. In 2022, the median interval between onset of stroke symptoms and hospital arrival was 3 hours and 2 minutes, a decrease of 28 minutes from 2021. Forty-seven percent of patients with a stroke were seen by a medical team within 10 minutes of hospital arrival, which was unchanged from 2021. However, this information was unknown in 575 cases. The number of admissions to a stroke unit remains unchanged (69%), and of those admissions, 68% of the total hospital stay was spent in a stroke unit. Both key performance indicators remain well below the target of 90%.

INAS National Reporting Table 2022

As part of the NOCA audit maturity process, the INAS data is now in a position where it can be presented in tabular format, by hospital, with key findings and trends reported in a condensed report and in summary format. The National Reporting Table aims to provide detailed stroke information to all our stakeholders, such as healthcare professionals, hospital managers, Hospital Groups, patients, and researchers. This extensive table is broken down into 9 data parts: 1. Data quality; 2. KQI Performance; 3. Case Mix; 4.Emergency care; 5. Stroke unit care; 6. Secondary prevention; 7. Outcomes; 8. Thrombectomy; and 9. HSCP.

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Key Recommendations

All hospitals should be resourced to participate fully in the Irish National Audit of Stroke (INAS).

The number of stroke unit beds should be increased so that at least 90% of patients with a stroke are cared for in a stroke unit.

Opportunistic screening for atrial fibrillation (AF) should be carried out for all people aged 65 years and over.

Clinicians and patients should be provided with guidance as to the importance of good adherence to anticoagulation medication in order to avoid strokes.

All hospitals should review their own performance against the national standards and identify quality improvement opportunities in order to improve the quality of care they are providing.