3e Congrès canadien de l’AVC

September 29 – October 2, 2012
Calgary, Alberta

Abstracts are welcome from national and international applicants from all disciplines and may be submitted in English or French and presented at the Congress in either language.

Each abstract should be a maximum of 300 words and consist of four paragraphs:

Background: briefly describing the problem or issue being addressed
Methods: describing how the study was performed
Results: describing the salient results or findings
Conclusions: describing what the authors conclude from these results.

Authors may submit multiple abstracts.

Learn more at www.strokecongress.ca.

Submit your abstract at www.strokecongress.com.

In order to maintain the integrity and currency of the guidelines, they undergo rigorous review and update every two years.  The update process for 2011 – 2013 has now begun.  With the technology available through the website, this year we will update individual sections as new research and information becomes available.  This will enable us to get practice changes communicated to all those who provide stroke care delivery in an efficient and timely manner.  All updates and changes will be posted on the website and will be accompanied by announcements of the site, in Brainwaves and through emails to all stakeholders.

CSN would gratefully like to acknowledge the healthcare experts who have kindly volunteered to chair the task groups who will be reviewing the literature and updating the recommendations and educational materials.

Chair, 2012 Best Practices Update: Dr. Gord Gubitz.

• Acute care task group:  Dr. Leanne Casaubon and Mr. Michael Suddes
• Stroke rehabilitation:  Dr. Andrew Dawson and Mr. Jason Knox
• Stroke Prevention:  Dr. Shelagh Coutts and Ms. Linda Kelloway
• Vascular Cognitive Impairment and Depression:  Dr. Gail Eskes
• Paediatric Stroke:  Dr. Adam Kirton

We are currently exploring several new topic areas that have been proposed for new recommendation development.  Decisions regarding inclusion are primarily based on the strength of the available research evidence to guide practice.  These areas include sleep apnea, hemicraniectomy, driving after stroke, vocational rehabilitation, and an expanded section on smoking cessation.

We encourage you to contact the stroke best practices office with any suggestions or input you may have as we proceed with the update process.  We can be reached through the ‘contact us’ section or at bestpractices@canadianstrokenetwork.ca.

A section on aphasia, tools for caregivers, as well as updated activity logs and personal recovery stories are among changes to the book.

To order your free copy, email us at info@canadianstrokenetwork.ca. Be sure to include your mailing address and the number of copies you want us to send.

The guide includes information on the signs and types of pediatric stroke, issues around rehabilitation and recovery and advice from kids to other kids and parents to other parents.

To order your free copy, email us at info@canadianstrokenetwork.ca. Be sure to include your mailing address and the number of copies you want us to send.

Canadians are not recognizing the symptoms of stroke

OTTAWA – A major national Canadian study on the quality of stroke care released today by the Canadian Stroke Network (CSN), one of Canada’s Networks of Centres of Excellence, finds that there is significant work to be done to improve prevention, treatment and recovery from stroke.

The study’s key findings include:

• Two thirds of stroke patients admitted to hospital do not arrive in time to receive the best possible stroke care.
• Stroke patients need greater access to stroke units;

• 77% of stroke patients do not receive treatment in a stroke unit.

• When patients arrive at hospital, they are not treated fast enough;

• Only 40% of patients who arrived within 3.5 hours of symptom onset received a CT (computed tomography) or MRI (Magnetic resonance imaging) scan within an hour of arrival.

• Patients receive good care in hospital but several aspects of stroke care need to be significantly improved;

• Only 12% of ischemic stroke patients admitted to a hospital with the capability to administer the important clot dissolving drug tPA were treated with the drug. Based on tPA rates at some of Canada’s top stroke centres, the target number could be triple the current rate for those ischemic strokes that arrive within the 3.5-hour window.

• Only 22% of the hospitals studied were affiliated with a secondary stroke prevention clinic.

• Access to rehabilitation is vital.

• Only 37% of moderate to severe strokes cases are discharged to a rehabilitation facility.

“The Quality of Stroke Care in Canada could not be timelier,” says Dr. Robert Côté, Chair of the study’s National Steering Committee and a Professor at McGill University. “The results of this study should be used to prioritize investments in stroke care and improve and monitor the quality of stroke care for all Canadians. Stroke is one of the leading causes of death and the main cause of neurological disability in Canada. The study will be of great value to our health system.”

“The study’s findings and recommendations are a ‘call to action’ to the Canadian stroke care community,” says Dr. Moira Kapral, a national steering committee member and Associate Professor, Faculty of Medicine and Department of Health, Policy Management and Evaluation at the University of Toronto. “There needs to be a greater emphasis on improving the public’s awareness about the early signs and symptoms of stroke and the importance of calling 9-1-1 and having an ambulance bring them to hospital immediately.”

The study looked at the quality of stroke care provided in emergency response, in-hospital care and in rehabilitation and recovery. Anonymous information from patients’ records was used and included: time of stroke symptom onset, timeliness of emergency medical system access, treatment received in the emergency department, acute inpatient care and information related to patient discharge from the acute care hospital.

“We are extremely pleased with the results of the study because it illustrates what can be achieved in stroke care in Canada. If Canada invests now in innovative and sustainable stroke care systems and programs—we will achieve real benefits such as saving more lives and reducing the impact of stroke,” says Dr. Antoine Hakim, CEO and Scientific Director of the Canadian Stroke Network.

The study included data from all health jurisdictions in Canada including government and health systems.

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To view the The Quality of Stroke Care in Canada and Backgrounder please go to:

• Backgrounder
• Download Study
• Read the report online (eMag) or on your mobile device.

For media assistance, please contact:

Cathy Campbell
Email: Cathy Campbell
Phone: 613-562-5696
Fax: 613-521-9215

About the Canadian Stroke Network (www.canadianstrokenetwork.ca)

The Canadian Stroke Network includes more than 100 of Canada’s leading scientists and clinicians from 24 universities who work collaboratively on various aspects of stroke. The Network, which is headquartered at the University of Ottawa, also includes partners from industry, the non-profit sector, provincial and federal governments. The Canadian Stroke Network, one of Canada’s Networks of Centres of Excellence, is committed to reducing the physical, social and economic impact of stroke on the lives of individual Canadians and on society as a whole.

Special thanks to Drs. Nicol Korner-Bitensky, Mark Bayley and Robert Teasell for their dedication and commitment to stroke rehabilitation and their leadership in ensuring the  latest rehabilitation evidence is included in the  2010 update.

“The adoption of these best practices will ensure stroke patients and families have rapid and seamless access to appropriate stroke services across the continuum and that they are well supported through these transitions,” says Patrice Lindsay, PhD, Director of Performance and Evaluation at the Canadian Stroke Network and one of the project leaders.

Among new recommendations:

• Blood pressure should be maintained at a level that is consistently lower than 140/90;
• Because atrial fibrillation (irregular heartbeat) increases stroke risk, patients with this condition should be closely monitored and the use of new drug therapies should be considered;
• Patients who have a mini-stroke (transient ischemic attack) should be referred immediately to a stroke specialist at a prevention clinic or to an emergency department due to increased risk of a major stroke;
• There should be more widespread use of telestroke – long-distance video and data hookups – between stroke specialists and communities where on- site stroke care does not exist; and
• Improved hospital discharge programs are needed, as well as better community services to enable people to return home sooner from hospital.

Thanks to earlier guidelines released in 2006 and 2008, more communities in Canada have an organized emergency response to stroke, stroke prevention clinics, specialized hospital stroke units, and improved rehabilitation services, all of which have been shown to save lives and reduce disability.

This is first time that this information has been pulled together in an easy-to-search and smart-phone friendly website – www.strokebestpractices.ca. The website includes resources to improve stroke and emergency services and to measure their effectiveness. It also includes a patient’s guide to optimal stroke care.

“Stroke is the third leading cause of death in Canada yet most strokes are preventable and treatable,” says Bobbe Wood, CEO of the Heart and Stroke Foundation of Canada. “Increasing awareness is a key part of the Canadian Stroke Strategy. The best practices website will provide optimal stroke resources and tools to the public and professionals such as physicians, emergency personnel, nurses, rehabilitation specialists and health policymakers.”

The Canadian Best Practice Recommendations for Stroke Care was developed as part of the Canadian Stroke Strategy, an initiative of the Canadian Stroke Network and Heart and Stroke Foundation of Canada to improve stroke care for people across the country. There are about 50,000 new strokes in Canada each year and 315,000 Canadians living with the after-effects of a stroke.

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The Canadian Stroke Network (canadianstrokenetwork.ca) brings together Canada’s leading scientists and clinicians to reduce the physical, social and economic impact of stroke on the lives of individual Canadians and on society as a whole.  Headquartered at the University of Ottawa, the Canadian Stroke Network is one of Canada’s Networks of Centres of Excellence.

The Heart and Stroke Foundation of Canada (heartandstroke.ca), a volunteer-based health charity, leads in eliminating heart disease and stroke and reducing their impact through the advancement of research and its application, the promotion of healthy living, and advocacy.

The Canadian Stroke Strategy (www.canadianstrokestrategy.ca) is a joint initiative of the Canadian Stroke Network and the Heart and Stroke Foundation of Canada. The goal of the Canadian Stroke Strategy is to help support an integrated approach to stroke prevention, treatment and rehabilitation in every province and territory by 2010.

Contact:

Cathy Campbell, Canadian Stroke Network

613-562-5696, 613-852-2303 (mobile)

Jane-Diane Fraser, Heart and Stroke Foundation of Canada

613-569-4361 x273

The Congress program committee will be chaired by Andrew Demchuk of the University of Calgary and Dale Corbett of the HSF Centre for Stroke Recovery. Program committee members include Gail Eskes of Dalhousie University, David Gladstone of Sunnybrook, Mayank Goyal of Hotchkiss Brain Institute, Teri Green of the National Stroke Nursing Council, Tony Hakim of the CSN, Michael Hill of the Calgary Stroke Program, Marc Poulin of the University of Calgary, Steffen-Sebastian Bolz, Associate Chair, Research, Dept. of Physiology, University of Toronto, Kelly Lumley-Leger of the Champlain Regional Stroke Program, Frank Nieboer of the stroke recovery community, Carol Richards of Universite Laval, Mike Sharma of the CSC and CSN, Bob Teasell of Parkwood Hospital, Andy Wielgosz of the Ottawa Heart Institute and CSN and HSFC staff.

Once again this year, the Congress will be co-hosted by the Canadian Stroke Network, Heart and Stroke Foundation of Canada and the Canadian Stroke Consortium.

A preliminary program will be posted at www.strokecongress.ca. Online abstracts will be accepted beginning in early February.

In 2010, more than 1,000 delegates attended the first Congress.

“This study shows that an urgent stroke prevention clinic can have a huge impact on preventing TIA patients from having a full-blown stroke,” said Dr. Mike Sharma, lead author of the study and Director of The Ottawa Hospital Stroke Clinic, Assistant Professor of Neurology at the University of Ottawa and Deputy Director of the Canadian Stroke Network. “Our stroke rate is a third of what it is at other centres, and we did this without costly hospitalization.”

The Ottawa Hospital Stroke Clinic was established in 2007 as part of a comprehensive stroke prevention program within the Champlain Local Health Integration Network. The clinic involves coordinated efforts between emergency room physicians, neurologists and nurses. Patients with TIA symptoms are rapidly assessed in the emergency department and referred to the stroke clinic for brain imaging, medication adjustments, counselling about stroke risk factors and, in some cases, surgery. An evidence-based triaging system ensures that patients with the greatest stroke risk are seen as quickly as possible.

“This study shows that it is critical to have systems in place to respond rapidly once it is clear that the brain is threatened,” said Dr. Antoine Hakim, Scientific Director of the Canadian Stroke Network and a stroke specialist and scientist affiliated with TOH and the University of Ottawa. “The results of this study are really encouraging. It’s a huge achievement.”

There are over 50,000 strokes in Canada each year and 300,000 Canadians living with the effects of stroke.

The study was funded by the Canadian Institutes of Health Research (CIHR).

“CIHR is pleased to support this wonderful study,” said Dr. Lori West, Scientific Director of CIHR’s Institute of Circulatory and Respiratory Health. “It is yet another powerful example of knowledge translation – research transforming the way we practice medicine, to improve the lives of Canadians.”

The full reference is: Stratified, Urgent Care for Transient Ischemic Attack Results in Low Stroke Rates. Wasserman J, Perry J, Dowlatshahi D, Stotts G, Stiell I, Sutherland J, Symington C, Sharma M. Stroke. 2010 Oct 14.