From the Foundation for Health Services Research, Central Hospital of
Akershus, Nordbyhagen, Norway.
Correspondence to Ole Morten Rønning, Foundation for Health Services Research, Central Hospital of Akershus, 1474 Nordbyhagen, Norway. E-mail bguldvog{at}sia.pilot.akershus-f.kommune.no
Background and Purpose—The long-term effect on survival
of treatment in stroke units is still under debate. The hypothesis that
a stroke unit with short length of stay increases 1-year and 18-month
survival rates was tested in this study.
Methods—A quasi-randomized, controlled study was undertaken
among 802 patients
Results—Case fatality within the first 10 days was 8.2%
among patients in the stroke unit and 15.1% among patients in the
general medical ward (P=.0019). One-year survival among
patients treated in the stroke unit was 70.6% and in the general
medical wards 64.6% (P=.026); 18-month survival rates were
65.1% and 58.0%, respectively (P=.021). Among patients
with cerebral hemorrhage, 10-day case fatality was 24.5% and
51.6% (P=.004) in favor of the stroke unit.
Conclusions—Stroke units increase survival rates among
stroke patients compared with general medical wards. The effect on
survival occurs early after the stroke and sustains during at least 18
months of observation.
© 1998 American Heart Association, Inc.
Original Contributions
Stroke Units Versus General Medical Wards, I: Twelve- and Eighteen-Month Survival
A Randomized, Controlled Trial
60 years old admitted to the Central Hospital of
Akershus in Norway with a diagnosis of stroke between January 1, 1993,
and February 1, 1995. All patients with onset of symptoms <24 hours
before admittance were included and enrolled and were followed until
death or to the end of the observation 18 months after stroke. Patients
were allocated to a stroke unit (n=364) or a general medical ward
(n=438).
Key Words: emergency medical services • outcome • stroke units • survival
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