From the Department of Medicine (B.I., F.B., S.A.S., R.R.), University
Hospital of Trondheim (Norway), 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 of acute stroke patients in the
combined acute and rehabilitation stroke unit in our hospital improves
survival and functional outcome compared with treatment in general
wards. The primary aim of the present trial was to examine whether
the treatment in our stroke unit had an effect on different aspects of
quality of life (QoL) for stroke patients 5 years after the onset
of stroke.
Methods—In a randomized controlled trial, 110 patients with
symptoms and signs of an acute stroke were allocated to the stroke unit
and 110 to general wards. No significant differences existed in
baseline characteristics between the two groups. The patients alive
after 5 years were assessed by the Nottingham Health Profile (NHP) and
the Frenchay Activities Index (FAI), which were the scales used as
primary outcome measures for QoL. As secondary outcome measures we used
a global score for the NHP and a simple visual analogue scale
(VAS).
Results—After 5 years, 45 of the patients treated in the stroke
unit and 32 of those treated in general wards were alive. All surviving
patients were assessed by the FAI. Thirty-seven (82.2%) of the stroke
unit patients and 25 (78.1%) of the general wards patients were
assessed by the NHP; 38 (84.4%) and 28 (87.5%), respectively, were
assessed by the VAS. Patients treated in the stroke unit had a higher
score on the FAI (P=0.0142). Assessment with the NHP
showed better results in the stroke unit group for the dimensions of
energy (P=0.0323), physical mobility
(P=0.0415), emotional reactions
(P=0.0290), social isolation (P=0.0089),
and sleep (P=0.0436), although there was no difference
in pain (P=0.3186). The global NHP score and VAS score
also showed significantly better results in the stroke unit group (NHP,
P<0.01; VAS, P<0.001). Patients who
were independent in activities of daily living had significantly better
QoL assessed by these scales than patients who were dependent.
Conclusions—Our study shows for the first time that stroke unit
care improves different aspects of long-term QoL for stroke patients.
© 1998 American Heart Association, Inc.
Original Contributions
Stroke Unit Treatment Improves Long-term Quality of Life
A Randomized Controlled Trial
Key Words: quality of life • stroke • stroke unit
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