Organised inpatient (stroke unit) care for stroke

Stroke patients who receive organised inpatient care in a stroke unit are more likely to be alive, independent, and living at home one year after the stroke than patients receiving less organised care e.g. on general wards.

A Cochrane review included 28 with a total of 5855 participants. Studies compared stroke unit care with an alternative service. Twenty-one trials (n=3994) compared stroke unit care with care provided in general wards. Stroke unit care showed reductions in the odds of death recorded at final (median one year) follow-up (OR 0.87, 95% CI 0.69 to 0.94; p=0.005), the odds of death or institutionalised care (OR 0.78, 95% CI 0.68 to 0.89; p=0.0003) and the odds of death or dependency (OR 0.79, 95% CI 0.68 to 0.90; p=0.0007). Sensitivity analyses indicated that the observed benefits remained when the analysis was restricted to securely randomised trials that used unequivocally blinded outcome assessment with a fixed period of follow-up. Outcomes were independent of patient age, sex, initial stroke severity or stroke type, and appeared to be better in stroke units based in a discrete ward. There was no indication that organised stroke unit care resulted in a longer hospital stay.

Ədəbiyyat

1. Stroke Unit Trialists' Collaboration. Organised inpatient (stroke unit) care for stroke. Cochrane Database Syst Rev 2013;9():CD000197. .