A non-intensive stroke unit reduces functional disability and the need for long-term hospitalization.

Abstract

In a prospective controlled trial the clinical outcome for unselected acute stroke patients in a non-intensive stroke unit (n = 110) and in general medical wards (n = 183) were compared. The patients were comparable in age, marital state and functional impairment on admission. Case fatality rates over the 1st yr after the stroke were similar in the 2 groups. By 3 mo. after the stroke, 15% of the survivors initially admitted to the stroke unit and 39% of those admitted to general medical wards remained hospitalized (P < 0.001). The corresponding figures by 1 yr after the cerebrovascular accident were 12% and 28%, respectively (P < 0.05). A greater proportion of surviving stroke unit patients was independent in walking (0.10 > P > 0.05), personal hygiene (P < 0.05) and dressing (P < 0.001). Essential features of the stroke unit are team work headed by a stroke nurse, staff, patient and family education and very early onset of rehabilitation. This strategy improves functional outcome and reduces the need for long-term hospital care.