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(Stroke. 2006;37:326.)
© 2006 American Heart Association, Inc.

Advances in Stroke 2005

Organized Stroke Care

From the Department of Neurology (B.N.), Lund University Hospital, Sweden; and the Department of Neurology (R.J.A.), Medical College of Georgia, Augusta, Ga, US.

Correspondence to Bo Norrving, MD, PhD, FESC, Department of Neurology, Lund University Hospital, S-221 95 Lund, Sweden. E-mail bo.norrving@med.lu.se

Key Words: stroke • stroke units • health care economics and organizations • health policy • outcome

An extract of the first 250 words of the full text is provided, because this article has no abstract.

The firm scientific basis for organized stroke care is relatively short, little more than 10 years. During the past year, existing knowledge has not only been consolidated but also extended in several areas with important implications on clinical practice. Three areas can be identified: (1) organization of prehospital services, (2) hospital treatment, and (3) follow-up care. Progress has been highly variable among the 3 areas and around the world based on local practices and differences in health care systems and resources. Overall, more progress is evident in hospital care, primarily creation and promotion of "stroke units".

Recent studies have supported the effectiveness of in-hospital organized (stroke unit) care,¹ and that management in a stroke rehabilitation unit confers survival benefits 10 years after stroke, probably because long-term survival is related to early reduction in disability.² An estimate based on data from the North East Melbourne Stroke Incidence Study showed that although tPA was the most potent intervention, management in stroke units had the greatest population benefit.³

Stroke unit care as provided in routine clinical practice in England, Wales, and Northern Ireland was associated with reduced case fatality by 25%,⁴ which is in line with previously reported data from the Swedish national registry of stroke care (Riks-Stroke),^5,6 and with the figure obtained from systematic analysis of stroke unit trial data. In a Japanese observational study, admission to an acute stroke unit during weekends and holidays, when level of multidisciplinary care and rehabilitation efforts was reduced, was associated with more unfavourable outcomes.⁷

Organization . . . [Full Text of this Article]

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