Consistency of the benefits of stroke units over years of operation:: an 8-year effectiveness analysis

被引:33
作者
Fuentes, B [1 ]
Díez-Tejedor, E [1 ]
Ortega-Casarrubios, MA [1 ]
Martínez, P [1 ]
Lara, M [1 ]
Frank, A [1 ]
机构
[1] UAM, Dept Neurol, Stroke Unit, La Paz Univ Hosp, E-28046 Madrid, Spain
关键词
stroke unit benefit; stroke outcome;
D O I
10.1159/000090529
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background: The efficacy of stroke units (SU) has been amply demonstrated in randomised trials. However, no long-term studies analysed their effectiveness in daily practice over several years of operation. Methods: Observational study from the stroke data bank of our neurology ward that includes consecutive stroke patients hospitalised since the SU was established in 1995 until the year 2002 (8 years). Clinical effectiveness was analysed in terms of mortality on day 7, in-hospital mortality, functional state at discharge, length of stay, in-hospital complications and long-term hospitalisation rates on a yearly basis using for comparisons chi(2) or Student t tests between the first and last 4 years of SU operation. Case-mix adjustments for baseline imbalances and stepwise multivariate logistic regression were also performed for comparative purposes. Results: 3,986 consecutive in-patients were included. No significant differences in the proportion of independent patients at discharge (73.9 vs. 74.5%; n. s.), length of stay (11.2 vs. 11.3 days; n. s.), in-hospital complications (25.0 vs. 25.9%; n. s.) or long-stay hospitalisation (6.3 vs. 6.4%; n. s.) were found comparing the first and last 4 years of SU operation. No significant differences in in-hospital mortality were found after adjustment by case-mix and length of stay. Conclusions: SU effectiveness, in terms of length of stay, death or dependence and long-term hospitalisation, is sustained over the period of operation. Copyright (c) 2006 S. Karger AG, Basel.
引用
收藏
页码:173 / 179
页数:7
相关论文
共 17 条
[1]   Multicenter comparison of processes of care between Stroke Units and conventional care wards in Australia [J].
Cadilhac, DA ;
Ibrahim, J ;
Pearce, DC ;
Ogden, KJ ;
McNeill, J ;
Davis, SM ;
Donnan, GA .
STROKE, 2004, 35 (05) :1035-1040
[2]   Role of monitoring in management of acute ischemic stroke patients [J].
Cavallini, A ;
Micieli, G ;
Marcheselli, S ;
Quaglini, S .
STROKE, 2003, 34 (11) :2599-2603
[3]   Stroke unit versus neurology ward - A short commentary [J].
Dennis, MS .
JOURNAL OF NEUROLOGY, 2003, 250 (11) :1370-1371
[4]   Effect of acute stroke unit care integrated with care continuum versus conventional treatment:: A randomized 1-year study of elderly patients -: The Goteborg 70+ stroke study [J].
Fagerberg, B ;
Claesson, L ;
Gosman-Hedström, G ;
Blomstrand, C .
STROKE, 2000, 31 (11) :2578-2584
[5]   The organization of attention in acute care of strokes.: Stroke units make the difference [J].
Fuentes, B ;
Díez-Tejedor, E ;
Lara, M ;
Frank, A ;
Barreiro, P .
REVISTA DE NEUROLOGIA, 2001, 32 (02) :101-106
[6]   Differences in long-term outcome between patients treated in stroke units and in general wards -: A 2-year follow-up of stroke patients in Sweden [J].
Glader, EL ;
Stegmayr, B ;
Johansson, L ;
Hulter-Åsberg, K ;
Wester, PO .
STROKE, 2001, 32 (09) :2124-2130
[7]   Stroke unit treatment -: 10-Year follow-up [J].
Indredavik, B ;
Bakke, F ;
Slordahl, SA ;
Rokseth, R ;
Håheim, LL .
STROKE, 1999, 30 (08) :1524-1527
[8]   BENEFIT OF A STROKE UNIT - A RANDOMIZED CONTROLLED TRIAL [J].
INDREDAVIK, B ;
BAKKE, F ;
SOLBERG, R ;
ROKSETH, R ;
HAAHEIM, LL ;
HOLME, I .
STROKE, 1991, 22 (08) :1026-1031
[9]   THE EFFECT OF A STROKE UNIT - REDUCTIONS IN MORTALITY, DISCHARGE RATE TO NURSING-HOME, LENGTH OF HOSPITAL STAY, AND COST - A COMMUNITY-BASED STUDY [J].
JORGENSEN, HS ;
NAKAYAMA, H ;
RAASCHOU, HO ;
LARSEN, K ;
HUBBE, P ;
OLSEN, TS .
STROKE, 1995, 26 (07) :1178-1182
[10]   Treatment and rehabilitation on a stroke unit improves 5-year survival -: A community-based study [J].
Jorgensen, HS ;
Kammersgaard, LP ;
Nakayama, H ;
Raaschou, HO ;
Larsen, K ;
Hübbe, P ;
Olsen, TS .
STROKE, 1999, 30 (05) :930-933