Indredavik B, Slørdahl S A, Bakke F, Rokseth R, Håheim L L
Department of Medicine, University Hospital of Trondheim, Norway.
Stroke. 1997 Oct;28(10):1861-6. doi: 10.1161/01.str.28.10.1861.
We have previously shown that treatment in our combined acute and rehabilitation Stroke Unit improves outcome during the first year after onset of stroke compared with stroke patients treated in general wards. The aim of the present trial was to examine the long-term effects of the stroke unit care.
In a randomized controlled trial, 110 patients with symptoms and signs of an acute stroke were allocated to the Stroke Unit and 110 to general wards. No significant differences existed in baseline characteristics between the two groups. The outcome after 5 years was measured by the proportion of patients at home, the proportion of patients in an institution, the mortality, and the functional state assessed by Barthel Index.
After 5 years, 38 (34.5%) of the patients randomized to the Stroke Unit and 20 (18.2%) of the patients randomized to the general wards were at home (P = .006). Sixty-five (59.1%) of the patients from the Stroke Unit and 78 (70.9%) of the patients from the general wards were dead (P = .041), while 7 (6.4%) and 12 (10.9%), respectively, were in an institution (e.g., nursing home) (P = NS). Functional state was significantly better for patients treated in the Stroke Unit.
For the first time it is shown that stroke unit care improves long-term survival and functional state and increases the proportion of patients able to live at home 5 years after the stroke. Combined acute and rehabilitation stroke units appear to be an effective way of organizing treatment for acute stroke patients.
我们之前已经表明，与在普通病房接受治疗的中风患者相比，在我们的急性与康复联合卒中单元接受治疗可改善中风发病后第一年的预后。本试验的目的是研究卒中单元护理的长期效果。
在一项随机对照试验中，110例有急性中风症状和体征的患者被分配至卒中单元，110例被分配至普通病房。两组的基线特征不存在显著差异。5年后的预后通过在家患者的比例、在机构中患者的比例、死亡率以及通过巴氏指数评估的功能状态来衡量。
5年后，随机分配至卒中单元的患者中有38例（34.5%）在家，而随机分配至普通病房的患者中有20例（18.2%）在家（P = .006）。卒中单元的65例（59.1%）患者和普通病房的78例（70.9%）患者死亡（P = .041），而分别有7例（6.4%）和12例（10.9%）在机构中（如养老院）（P = 无显著性差异）。在卒中单元接受治疗的患者功能状态明显更好。
首次表明卒中单元护理可改善长期生存率和功能状态，并增加中风5年后能够在家生活的患者比例。急性与康复联合卒中单元似乎是为急性中风患者组织治疗的有效方式。
