Cochrane Database Syst Rev. 2007 Oct 17(4):CD000197. doi: 10.1002/14651858.CD000197.pub2.
Organised stroke unit care is provided by multidisciplinary teams that exclusively manage stroke patients in a dedicated ward (stroke, acute, rehabilitation, comprehensive), with a mobile stroke team or within a generic disability service (mixed rehabilitation ward).
To assess the effect of stroke unit care compared with alternative forms of care for patients following a stroke.
We searched the Cochrane Stroke Group trials register (last searched April 2006), the reference lists of relevant articles, and contacted researchers in the field.
Randomised and prospective controlled clinical trials comparing organised inpatient stroke unit care with an alternative service.
Two review authors initially assessed eligibility and trial quality. Descriptive details and trial data were then checked with the co-ordinators of the original trials.
Thirty-one trials, involving 6936 participants, compared stroke unit care with an alternative service; more organised care was consistently associated with improved outcomes. Twenty-six trials (5592 participants) compared stroke unit care with general wards. Stroke unit care showed reductions in the odds of death recorded at final (median one year) follow up (odds ratio (OR) 0.86; 95% confidence interval (CI) 0.76 to 0.98; P = 0.02), the odds of death or institutionalised care (OR 0.82; 95% CI 0.73 to 0.92; P = 0.0006) and death or dependency (OR 0.82; 95% CI 0.73 to 0.92; P = 0.001). Sensitivity analyses indicated that the observed benefits remained when the analysis was restricted to trials that used formal randomisation procedures with blinded outcome assessment. Outcomes were independent of patient age, sex or stroke severity, but appeared to be better in stroke units based in a discrete ward. There was no indication that organised stroke unit care resulted in a longer hospital stay.
AUTHORS' 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 benefits were most apparent in units based in a discrete ward. No systematic increase was observed in the length of inpatient stay.
有组织的卒中单元护理由多学科团队提供，这些团队在专门的病房（卒中、急性、康复、综合病房）、移动卒中团队或一般残疾服务机构（混合康复病房）中专门管理卒中患者。
评估卒中单元护理与卒中后患者其他护理形式相比的效果。
我们检索了Cochrane卒中组试验注册库（最后检索时间为2006年4月）、相关文章的参考文献列表，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其他服务的随机和前瞻性对照临床试验。
两位综述作者最初评估了纳入标准和试验质量。然后与原始试验的协调员核对描述性细节和试验数据。
31项试验，涉及6936名参与者，比较了卒中单元护理与其他服务；更有组织的护理始终与更好的结果相关。26项试验（5592名参与者）比较了卒中单元护理与普通病房。卒中单元护理显示，在最终（中位一年）随访时记录的死亡几率降低（优势比（OR）0.86；95%置信区间（CI）0.76至0.98；P = 0.02），死亡或机构护理的几率降低（OR 0.82；95%CI 0.73至0.92；P = 0.0006）以及死亡或依赖的几率降低（OR 0.82；95%CI 0.73至0.92；P = 0.001）。敏感性分析表明，当分析仅限于使用正式随机化程序和盲法结局评估的试验时，观察到的益处仍然存在。结局与患者年龄、性别或卒中严重程度无关，但在独立病房的卒中单元中似乎更好。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。
在卒中单元接受有组织的住院护理的卒中患者在卒中后一年更有可能存活、独立并在家中生活。这些益处在独立病房的单元中最为明显。未观察到住院时间有系统性增加。
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