Spiros Denaxas: National Linked Health Records Reveal Stroke Care Gaps England During and After COVID-19
Spiros Denaxas, Professor of Biomedical Informatics at UCL, shared on LinkedIn about a recent article he and his colleagues co-authored, published in BMJ Open, adding:
”Excited to share our new paper in BMJ Open led by James Farrell and William Whiteley, a national study of stroke care quality using linked electronic health records across England during and after the COVID-19 pandemic.
We linked SSNAP, primary care (GDPPR), hospital admissions (HES), dispensed medications (NHSBSA) and mortality records for 425,675 adults with a first stroke (2020–2023) via NHS England’s Secure Data Environment.
Key findings:
- Combining all data sources captured strokes missed by any single source alone — 10.8% of non-fatal ischaemic strokes appeared only in primary care, and 19.4% of fatal strokes only in death records.
- Standardised stroke incidence rose from 228 to 245 per 100,000 over the study period, with COVID-19 lockdowns shifting cases from healthcare encounters to deaths.
- Secondary prevention gaps persist: while ~89% of ischaemic stroke patients received antithrombotic therapy, only 44.5% were dispensed antihypertensives — a pattern driven by age and comorbidity, not the pandemic.
- ‘Home-time’ (days alive and out of hospital in 180 days post-stroke) proved a sensitive, person-centred outcome metric, exposing disparities by deprivation, severity and region.”
Title: Measurement of quality of stroke care with national electronic health records: a prospective cohort study during and after the COVID-19 pandemic
Authors: James Farrell, John Nolan, Roger Lambert, Ana Torralbo, Steffen E Petersen, Mevhibe Hocaoglu, Chris Tomlinson, Reecha Sofat, Qi Huang, Evan Kontopantelis, Martin James, Sarah Lessels, Jacqueline A L MacArthur, Angela M Wood, William N Whiteley, Spiros Denaxas
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