Stroke, Vol 22, 1026-1031, Copyright © 1991 by American Heart Association
B Indredavik, F Bakke, R Solberg, R Rokseth, LL Haaheim and I Holme
In a randomized controlled trial we compared the clinical outcome of acute
stroke patients, 110 of whom were allocated to treatment in a stroke unit
and 110 to treatment in general medical wards. No significant difference
existed between these groups with regard to sex, age, marital status,
medical history, or functional impairment on admission. Outcome was
measured at 6 and 52 weeks after the stroke by the proportion of patients
at home, the proportion of patients in an institution, the mortality, and
the functional state. After 6 weeks 56.4% of the patients randomized to the
stroke unit and 32.7% of the patients randomized to the general medical
wards were at home (p = 0.0004), and after 52 weeks 62.7% and 44.6%,
respectively, were at home (p = 0.002). After 6 weeks 36.3% of the patients
from the stroke unit and 50.0% from the general medical wards were in an
institution (p = 0.02); after 52 weeks 12.7% and 22.7%, respectively, were
institutionalized (p = 0.016). After 6 weeks mortality was 7.3% for the
stroke unit group and 17.3% for the general medical wards group (p =
0.027). After 52 weeks mortality was 24.6% for the stroke unit group and
32.7% for the general medical wards group (difference not significant).
Functional state was significantly better for patients treated in the
stroke unit after both 6 and 52 weeks. We conclude that care of patients
with acute stroke in a stroke unit improves clinical outcome compared with
treatment in general medical wards.
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Benefit of a stroke unit: a randomized controlled trial
Department of Medicine, University Hospital of Trondheim, Norway.
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