Fuentes Blanca, Díez-Tejedor Exuperio, Ortega-Casarrubios M Angeles, Martínez Patricia, Lara Manuel, Frank Ana
Stroke Unit, Department of Neurology, La Paz University Hospital, Madrid, Spain.
Cerebrovasc Dis. 2006;21(3):173-9. doi: 10.1159/000090529. Epub 2005 Dec 23.
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.
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 chi2 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.
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.
SU effectiveness, in terms of length of stay, death or dependence and long-term hospitalisation, is sustained over the period of operation.
卒中单元（SU）的疗效已在随机试验中得到充分证明。然而，尚无长期研究分析其在数年运营中的日常实践效果。
对我们神经内科病房卒中数据库进行观察性研究，纳入自1995年卒中单元设立至2002年（8年）期间连续住院的卒中患者。从第7天死亡率、住院死亡率、出院时功能状态、住院时间、住院并发症以及每年的长期住院率等方面分析临床疗效，使用卡方检验或学生t检验对卒中单元运营的前4年和后4年进行比较。为了进行比较，还对基线不平衡进行了病例组合调整，并进行了逐步多变量逻辑回归分析。
共纳入3986例连续住院患者。比较卒中单元运营的前4年和后4年，出院时独立患者比例（73.9%对74.5%；无显著性差异）、住院时间（11.2天对11.3天；无显著性差异）、住院并发症（25.0%对25.9%；无显著性差异）或长期住院率（6.3%对6.4%；无显著性差异）均未发现显著差异。经病例组合和住院时间调整后，住院死亡率无显著差异。
卒中单元在住院时间、死亡或依赖以及长期住院方面的有效性在运营期间得以维持。
