Academic Section of Geriatric Medicine, 3rd Floor, Centre Block, Royal Infirmary, Glasgow, UK, G4 0SF.
Cochrane Database Syst Rev. 2000(2):CD000197. doi: 10.1002/14651858.CD000197.
Specially organised stroke units can be a ward or team that exclusively manages stroke patients (a dedicated stroke unit) or a ward or team that provides a generic disability service (a mixed assessment or rehabilitation unit).
The objective of this review was to assess the effect of care in a stroke unit compared with conventional care of patients following a stroke.
We searched the Cochrane Stroke Group trials register, reference lists of articles and contacted researchers in the field.
Randomised and quasi-randomised trials comparing organised inpatient stroke unit care with conventional care.
Two reviewers independently assessed eligibility and trial quality. The principal reviewer conducted a structured interview with the coordinators of unpublished trials.
Twenty trials were included. Stroke unit care showed a reduction in the odds of death recorded at final follow-up (median one year). The odds ratio was 0.83, 95% confidence interval 0.71 to 0.97. The odds of death or institutionalised care were lower (0.76, 95% confidence interval 0.65 to 0.90) as were death or dependency at final review (odds ratio 0.75, 95% confidence interval 0.65 to 0.87). Subgroup analyses showed that the observed benefits were independent of patient age, sex, stroke severity, and types of stroke unit organisation. There was no indication that organised stroke unit care resulted in increased hospital stay, although there was heterogeneity between the trials.
REVIEWER'S CONCLUSIONS: Stroke patients who receive organised inpatient care in a stroke unit are more likely to be alive, independent, and living at home one year after the stroke. The apparent benefits are not restricted to any particular sub-group of patients or model of stroke unit care. No systematic increase was observed in the length of inpatient stay.
专门设立的卒中单元可以是专门管理卒中患者的病房或团队（专门的卒中单元），也可以是提供综合残疾服务的病房或团队（混合评估或康复单元）。
本综述的目的是评估卒中单元护理与卒中患者常规护理相比的效果。
我们检索了Cochrane卒中组试验注册库、文章参考文献列表，并联系了该领域的研究人员。
比较有组织的住院卒中单元护理与常规护理的随机和半随机试验。
两名评价员独立评估入选资格和试验质量。主要评价员对未发表试验的协调员进行了结构化访谈。
纳入了20项试验。卒中单元护理显示，在最终随访（中位时间为1年）时记录的死亡几率降低。优势比为0.83，95%置信区间为0.71至0.97。死亡或机构护理的几率较低（0.76，95%置信区间为0.65至0.90），最终复查时死亡或依赖的几率也较低（优势比0.75，95%置信区间为从0.65至0.87）。亚组分析表明，观察到的益处与患者年龄、性别、卒中严重程度和卒中单元组织类型无关。没有迹象表明有组织的卒中单元护理会导致住院时间延长，尽管试验之间存在异质性。
在卒中单元接受有组织的住院护理的卒中患者在卒中后1年更有可能存活、独立并在家中生活。明显的益处不限于任何特定的患者亚组或卒中单元护理模式。未观察到住院时间有系统性增加。
