Each year there are up to 48,000 stroke events among Australians
(Thrift et al. 2000 & Senes S, 2006). Following stroke, up to 50% of patients have a temperature above 37.5°C (Castillo et al. 1998) and up to 50% of patients become hyperglycaemic (Scott et al. 1999). Both increase the amount of brain tissue adversely affected by the stroke, which increases disability (Parsons et al. 2002 & Reith et al. 1996). Up to three quarters of stroke patients experience swallowing difficulties and are three times more likely to develop pneumonia than those without swallowing problems (Martino et al. 2005).
The QASC trial was conducted throughout 19 NSW stroke units from 2005 – 2011 (ACTRN12608000563369). This project developed, implemented and rigorously evaluated, using a clustered randomised controlled trial design, an intervention to improve evidence-based management of fever, hyperglycaemia and swallowing management in the first 72 hours following acute stroke.
Our results showed that patients who were cared for in stroke units that were randomised to the intervention arm of the study were more likely to be alive and independent at 90 days when compared with patients who were cared for in stroke units who had been allocated to the control arm. They were also more likely to have their temperature and blood glucose monitored and to receive a swallow screen within 24 hours.
Full details of the study, are available on the QASC publications, including the study protocol, pre-intervention cohort data and the final results.