Barreiro Tella P, Díez Tejedor E, Frank García A, Lara Lara M, Fuentes B
Servicio de Neurología. Unidad de ictus.; Hospital General Universitario La Paz, Madrid, 28046, España.
Rev Neurol. 2001;32(2):101-6.
The advantages of care in stroke units (UI) are known, as are those of being in neurology wards as compared with the general medical wards, although to date there are no studies which make a comparative evaluation of the stroke team (EI) as compared with the UI with regard to benefits in care obtained by the patients.
We made a sequential analysis from the stroke register comparing three groups of patients attended during the years 1994-1996. During 1994 the patients were attended in the neurology ward by the EI. In 1995 an acute UI was set up. The criteria for inclusion or exclusion, health staff and technical resources were similar. We analysed the average stay, complications, mortality, hospital costs, functional state and destination on discharge.
We included 1,491 patients: 435 (1994), 529 (1995) and 527 (1996). Comparing UI with EI we observed a reduced average stay (29.5%; p<0.001), fewer complications (47.8%; p<0.001), better functional state on discharge (Rankin 1 +/- 2 against 2 +/- 2; p<0.0001), increased transference to rehabilitation units (78%; p<0.001) with less long-term hospitalisation (22%; VS) and a reduction in costs ( up to 14.2%). There was no difference in mortality.
The UI is a better system of attendance than EI for the management of strokes, since it reduces the average stay, hospital complications and health costs, as well as permitting a better functional state on discharge. Therefore treatment in the UI makes the difference in prognosis for these patients and the institutional expenses.
卒中单元（UI）护理的优势是众所周知的，与普通内科病房相比，在神经内科病房接受护理的优势也是如此，尽管迄今为止，尚无研究对卒中团队（EI）与UI在患者获得的护理益处方面进行比较评估。
我们对卒中登记册进行了序贯分析，比较了1994年至1996年期间接受治疗的三组患者。1994年，患者在神经内科病房由EI进行护理。1995年设立了急性UI。纳入或排除标准、医护人员和技术资源相似。我们分析了平均住院时间、并发症、死亡率、医院成本、功能状态和出院去向。
我们纳入了1491例患者：1994年435例，1995年529例，1996年527例。将UI与EI进行比较，我们观察到平均住院时间缩短（29.5%；p<0.001），并发症减少（47.8%；p<0.001），出院时功能状态更好（Rankin 1±2对比2±2；p<0.0001），转至康复单元的比例增加（78%；p<0.001），长期住院减少（22%；VS），成本降低（高达14.2%）。死亡率无差异。
对于卒中管理，UI是比EI更好的护理系统，因为它缩短了平均住院时间、减少了医院并发症和医疗成本，还能使出院时功能状态更好。因此，在UI进行治疗对这些患者的预后和机构费用有重要影响。
