Stroke and ischaemic attack: mortality within 30 days

Indicator type

Network / system level indicator. The indicator would be appropriate to understand and report on the performance of networks or systems of providers.

Rationale

This indicator measures mortality from stroke and seeks to encourage improvements in the prompt diagnosis and treatment of stroke to reduce mortality. Some (but not all) deaths within a defined period after admission to hospital may be avoidable through high-quality coordinated specialist stroke care.

Source guidance

Stroke and transient ischaemic attack in over 16s: diagnosis and initial management. NICE guideline NG128 (2019, updated 2022)

Specification

Numerator: The number in the denominator that have a mortality record within 30 days of being admitted to hospital, including deaths that occur in or out of hospital.

Denominator: The number of Sentinel Stroke National Audit Programme (SSNAP) records where the patient was admitted with a primary diagnosis of one or more of the following codes (see below)

Calculation: Numerator divided by the denominator, multiplied by 100.

Definitions for denominator (SSNAP Governance - audit design):

Exclusions: People under 16.

Data source: SSNAP: 30-day case mix adjusted mortality after stroke. Publicly available data is published annually.

Expected population size: SSNAP National results – clinical: results portfolio, admissions and discharges for April 2022 to March 2023 (case mix and denominator information) and The Office of National Statistics (2024) estimates of the population for the UK, England, Wales, Scotland and Northern Ireland, mid-2022 edition (MYE1: summary for the UK, England, all persons) show that 0.16% of people in England were admitted with a primary diagnosis of stroke: 16 per 10,000 patients served by a network. There is no minimum number of patients required for network level indicators. However, consideration should be given to whether the majority of results would require suppression because of small numbers.