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In a randomized controlled trial we compared the clinical outcome of acute stroke patients,110 of whom were allocated to treatment in a stroke unit and 110 to treatment in general medical wards.No significant difference existed between these groups with regard to sex,age,marital status,medical history,or functional impairment on admission.Outcome was measured at 6 and 52 weeks after the stroke by the proportion of patients at home,the proportion of patients in an institution,the mortality,and the functional state.After 6 weeks 56.4%of the patients randomized to the stroke unit and 32.7%of the patients randomized to the general medical wards were at home (p=0.0004),and after 52 weeks 62.7%and 44.6%,respectively,were at home(p= 0.002).After 6 weeks 36.3%of the patients from the stroke unit and 50.0% from the general medical wards wer ein an institution(p=0.02);after 52 weeks 12.7%and 22.7%,respectively,were institutionalized(p=0.016).After 6 weeks mortality was 7.3%for the stroke unit group and 17.3%for the general medical wards group(p=0.027).After 52 weeks mortality was 24.6%for the stroke unit group and 32.7%for the general medical wards group(difference not significant).Functional state was significantly better for patients treated in the stroke unit after both 6 and 52 weeks.We conclude that care of patients with acute stroke in a stroke unit improves clinical outcome compared with treatment in general medical wards. |
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