ACUTE STROKE TREATMENT IN UK HOSPITALS - THE STROKE ASSOCIATION SURVEY OF CONSULTANT OPINION

The aim of the Stroke Association survey was to document United Kingdo m consultant opinion of the immediate treatment for patients with acut e stroke. A national postal survey of all UK hospital consultant gener al physicians, geriatricians and neurologists was carried out in 1992/ 3. We identified 1,953 consultants who routinely cared for patients wi th acute stroke; 39% of them regularly used aspirin for patients with acute stroke and 10% used low-dose subcutaneous heparin. Other treatme nts were rarely used. There was much uncertainty about the effectivene ss of all currently available acute stroke treatments; 73% of physicia ns were prepared to start aspirin before a CT scan, but a much smaller proportion would start heparin therapy without one. Twenty-seven perc ent of consultants would actively treat hypertension in the initial 24 hours after stroke. Routine aspirin for secondary prevention after is chaemic stroke was widely accepted, but blood cholesterol lowering by drugs was not. In conclusion, aspirin and heparin alone are the only r outinely used treatments for the immediate treatment of acute stroke; other treatments are used sparingly or not at all. The great uncertain ty about the value of all available acute stroke treatments should enc ourage participation in randomised controlled trials.