Watching out for the details may help

The right treatment might be the key to success. A recent story gave the results of Australian research showing that certain after-stroke treatments may boost outcome:

"Clinical leaders of stroke services can adopt this strategy with confidence that their outcomes will improve," Sandy Middleton, a professor at the Nursing Research Institute at St. Vincent's & Mater Health in Sydney, Australia, and colleagues wrote in the report in the Oct. 12 online edition of The Lancet.

The researchers noted that patients who recover in units devoted to stroke care often experience fever (20 to 50 percent of patients), high blood sugar (up to half of patients) and problems swallowing (37 to 78 percent of patients) within the first few days of a stroke. These conditions "are not yet universally well managed," the study authors indicated.

In the study, Middleton and colleagues randomly assigned patients at 19 stroke units in New South Wales, Australia, to different types of treatment. Some followed existing guidelines, while others adopted new protocols involving monitoring of fever and high blood sugar plus treatment for the conditions. Nurses also underwent special training to treat swallowing problems in the patients.

Within 90 days, 42 percent of the 558 patients in the group that received the special treatment were dead or considered to be dependent, compared with 58 percent of the 449 patients who received the existing treatment, the investigators reported.

Patients who received the special treatment also scored better on a test of their physical functioning, the results showed.

This also shows the value of an advocate for every stroke patient to help manage these conditions - fever, blood sugar and problems with swallowing. My wife was my advocate after my stroke, when I could not, literally, speak for myself. I'm convinced that her efforts greatly improved my outcome. Thank God for my advocate.

(Photo from the National Institutes of Health)