(Stroke. 1999;30:1524-1527.)
© 1999 American Heart Association, Inc.
Original Contributions |
Stroke Unit Treatment
10-Year Follow-Up
From the Department of Medicine (B.I., F.B., S.A.S., R.R.,) University Hospital of Trondheim, and The Life Insurance Companies' Institute of Medical Statistics (L.L.H.), Ullevaal Hospital, Oslo, Norway. Correspondence to Dr Bent Indredavik, The Stroke Unit, Department of Medicine, University Hospital of Trondheim, N-7006 Trondheim, Norway.
Background and Purpose—We have previously shown that treatment in our combined acute and rehabilitation stroke unit (SU) improves the outcome during the first 5 years after onset of stroke compared with that for stroke patients treated in general wards (GW). The aim of the present trial was to examine the effects of SU care after 10 years of follow-up.
Methods—In a randomized controlled trial, 110 patients with
symptoms and signs of an acute stroke were allocated to the SU and 110
to GW. No significant differences existed in baseline characteristics
between the groups. The outcome after 10 years was measured by the
proportion of patients at home, the proportion of patients in an
institution, the mortality, and the functional state as assessed by the
Barthel Index, in which a Barthel Index score of 
60 was classified as
independent or partly independent and a score of 95 was classified as
independent.
Results—After 10 years, 21 (19.1%) of the patients randomized to
the SU and 9 (8.2%) of the patients randomized to the GW were at home
(P=0.0184). Eighty-three (75.5%) of the patients from
the SU and 96 (87.3%) of the patients from the GW were dead
(P=0.0082), and 6 (5.4%) and 5 (4.5%), respectively,
were in an institution (eg, nursing home; NS). Twenty-two (20.0%) of
the SU patients and 9 (8.2%) of the GW patients had a Barthel Index
score of 60 (P=0.0118), and 14 (12.7%) and 6 (5.4%),
respectively, had a score of 95 (P=0.0606).
Conclusions—For the first time it has been shown that SU care improves survival and functional state and increases the proportion of patients able to live at home 10 years after their stroke. Treatment in combined acute and rehabilitation SU seems to have important long-term effects on outcome for stroke patients.
Key Words: randomized controlled trials • stroke management • stroke units • treatment outcome
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