The research, which was published in Stroke on 10 November, was carried out by the Institute of Cardiovascular Research at Royal Holloway, University of London and St Peters Hospital in Chertsey and reveals errors were being made in the dosage because clinicians were poor at guessing the weight of patients, particularly the heaviest patients irrespective of age, gender or presence of other diseases.
Overall, 7% of the 242 patients studied received an incorrect dose. However, in patients weighing over 80kg who made up a third of the study, this increased to approximately 20% receiving an incorrect (usually by 10% too little) dose of the clot busting drug. At discharge these patients had on average 10% poorer outcome.
Those patients who had been accurately dosed where seen to have the greatest functional improvement at discharge.
Lead researcher Professor Pankaj Sharma from the Institute of Cardiovascular Research at Royal Holloway, said: “Our study has revealed that patients are being given the wrong dose of up to 10% of the amount they should receive which is resulting in poorer outcomes. This was the case in 20% of the heaviest patients, which made up a third of the studied population.
If we were to extrapolate this data to the approximately 150,000 individuals that suffer a stroke annually in the UK then it would mean around 10,000 stroke victims per year are receiving the wrong dose, potentially impacting on their final functional outcome.”
The researchers have made a recommendation that all emergency/A&E departments in the UK have at least one automatic weighing bed and that this should be mandated across the NHS.
A simple automatic weighing accessory for a hospital bed can cost as little as a few hundred pounds but potentially save the NHS millions of pounds in terms of better stroke outcome and reduced morbidity.
Professor Sharma added: “I would struggle to think of an alternative intervention for stroke that would benefit so many patients, in so short a time, for so little money.”
Royal Holloway, University of London