[Results of a survey of different types of stroke care in France: from stroke unit to conventional care].

INTRODUCTION

Stroke is a worldwide problem with high incidence, mortality and disability rates. A Meta analysis by the Stroke Unit Trialist Collaboration showed that stroke units improve outcome for stroke patients. Stroke care should take place in stroke units which consist of a hospital unit or part of a hospital unit that exclusively takes care of stroke patients. European recommendations have been published by the European Stroke Initiative and French recommendations by the Societe Française Neurovasculaire.

METHODS

We sent a questionnaire to French stroke physicians in order to establish the different types of stroke care for French inpatients.

RESULTS

About half the people surveyed answered (106/193) and we selected 74 responses in order to have only one response for each hospital. Thus, we analysed 74 responses from 74 different French hospitals, coming from the whole country. Of the 74 hospitals, 23 had a stroke unit, 21 had dedicated beds for stroke inpatients, and 30 had no specific care. We identified 5 different types of stroke units: those with intensive acute care and post acute care (8/23), those with intensive acute care that were coordinated with a neurology department (7/23), those with beds in the neurology department (3/23), one with three levels (emergency, acute care and post acute care) and one that shared intensive care with cardiology. Structures of 3 stroke unit couldn't be identified. We studied their conformity to the recommended guidelines and found that, in most cases, they followed them closely. We studied differences between hospitals with stroke units and hospitals without stroke units in terms of technical or human means. We founded only a few differences between these two groups in the advantage of stroke units over hospitals without stroke units.

DISCUSSION

We found major differences of organisation between different types of stroke units, but no differences between hospitals with stroke units and other hospitals. These stroke units are generally in conformity with the recommended guidelines.