Cabral Norberto L, Moro Carla, Silva Giana R, Scola Rosana Herminia, Werneck Lineu César
Univille Regional University Region, Joinville, SC, Brazil.
Arq Neuropsiquiatr. 2003 Jun;61(2A):188-93. doi: 10.1590/s0004-282x2003000200006. Epub 2003 Jun 9.
To assess the impact of a stroke unit (SU) on acute phase treatment when compared to a conventional general ward treatment (GW).
Seventy-four patients with acute stroke were randomized between a SU and conventional general ward (GW). We compared both groups regarding the length of hospital stay, lethality and functional and clinical status within 6 months, using the Scandinavian scale and Barthel index.
Thirty-five and thirty-nine patients were allocated at SU and GW, respectively. Lethality on the 10th day at SU and GW achieved 8.5% and 12.8% respectively (p= 0.41), whereas 30-days mortality rates achieved 14.2% and 28.2% (p= 0.24), 17.4% and 28.7% on the 3rd month (p= 0.39), and 25.7% and 30.7% on the 6th month (p= 0.41). Thirty-day survival curve achieved 1.8 log rank (p= 0.17), with a trend for lower lethality in the SU. In order to save one death in 6 months in SU, NNT (the number need to treat) was 20; to get one more home independent patient NNT was 15. No significant difference was found between the length of hospital stay and morbidity.
No significant benefit was found in SU patients compared to GW group. However,an evident benefit in absolute numbers was observed in lethality, survival curve and NNT in thirty days period after stroke. Further collaborative studies or incresead number of patients are required to define the role of SU.
评估卒中单元（SU）与传统普通病房治疗（GW）相比对急性期治疗的影响。
74例急性卒中患者被随机分配至卒中单元和传统普通病房。我们使用斯堪的纳维亚量表和巴氏指数比较了两组患者的住院时间、死亡率以及6个月内的功能和临床状况。
分别有35例和39例患者被分配至卒中单元和普通病房。卒中单元和普通病房第10天的死亡率分别为8.5%和12.8%（p = 0.41），30天死亡率分别为14.2%和28.2%（p = 0.24），第3个月分别为17.4%和28.7%（p = 0.39），第6个月分别为25.7%和30.7%（p = 0.41）。30天生存曲线的对数秩为1.8（p = 0.17），卒中单元的死亡率有降低趋势。为了在卒中单元6个月内挽救1例死亡患者，需治疗人数（NNT）为20；为了多获得1例居家独立患者，NNT为15。住院时间和发病率方面未发现显著差异。
与普通病房组相比，卒中单元患者未发现显著益处。然而，在卒中后30天内的死亡率、生存曲线和NNT方面，绝对数量上有明显益处。需要进一步的合作研究或增加患者数量来明确卒中单元的作用。
