Nimhans proposes hospital cluster for stroke and trauma-related care

Nimhans has submitted a Rs 6.31-crore proposal to the state government to set up a hub-and-spoke cluster for acute stroke, neurocritical, and trauma care in Bengaluru and other districts of Karnataka.

About 25% of patients presenting to emergency in Nimhans are stroke victims, accounting for nearly 250 a month. A majority of secondary- and tertiary-care state-run hospitals in and around Bengaluru refer most acute stroke patients to Nimhans.

“While Nimhans admits and treats all stroke patients in the golden hour, majority of them presenting to Nimhans emergency are referred back since they are beyond the golden hour for acute stroke care,” said Dr Prathima Murthy, director of Nimhans.

“Most of the patients are lost to follow up from the medical system due to the absence of an orderly approach to refer them back. It is an important public health deficiency as a significant number of patients may get a recurrence of a more debilitating stroke or heart attack in the absence of appropriate risk-control factors,” she said.

The proposal is to develop a network of government hospitals that can cater to different aspects of acute stroke care, all linked and mentored online to a Nimhans acute stroke care command centre (NASCCC). It would provide mentoring and support for the development of local hubs and spokes.

The model would be first incubated for Bengaluru and neighbouring districts. Based on inputs from the model, the system would be scaled up to other localities in Karnataka with medical college hospitals as the local hub. With the country’s largest neurology department consisting of 25 faculty members and 50 interns, Nimhans functions as an apex centre. While 95% of the treatment is free, those paying for their treatment find their bills to be three to five times less than corporate hospitals.

In Karnataka, stroke contributes to 4.7% of all disability-adjusted life years, a measure of overall disease burden expressed as the number of years lost to ill-health, disability, or early death. Being the second most common cause of death, stroke incidents are recorded as 119 to 145 per lakh each year. The number of new patients per one crore population is 11,900 to 14,500 each year.

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