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KMID : 0359720090270020116
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Journal of the Korean Neurological Association
2009 Volume.27 No. 2 p.116 ~ p.122
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Differences of Mortality and Dependence Between Stroke Unit and General Ward Care in Acute Ischemic Stroke Patients
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Ko Young-Chai
Kwon O-Ki
Jung Cheol-Kyu
Bae Hee-Joon
Kim Wook-Joo
Oh Chang-Wan
Paik Nam-Jong
Han Moon-Ku
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Abstract
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Background:There is strong evidence for the efficacy of stroke unit (SU) care, which has become a common practice in other developed countries but is available only in a small number of centers in Korea. This late introduction of SU care in Korea can be at least partly attributed to doubts about its benefits on patient outcomes compared to general ward (GW) care in our routine practice.
Methods: Based on a prospective stroke registry, we identified 1,300 acute stroke patients hospitalized in either SUs (n=195) or GWs (n=1,105) from January 2004 to June 2008. Clinical outcomes such as fatality and disability rates were compared using propensity score matching in the total cohort. Additional statistical adjustments were performed using stepwise logistic regression analyses with the backward elimination method for potential confounders.
Results: The baseline characteristics did not differ significantly between patients admitted to SUs (n=195) and their matched controls (n=386). The 3-month dependency rate was 17.4% in SUs and 21.0% in GWs (p=0.31), and the case fatality rates were 1.5% and 8.0% (p<0.001), respectively. Adjusted odds ratios for SU care were 0.49 for dependency (95% confidence interval [CI]=0.22-1.08) and 0.17 for death (95% CI=0.04-0.83).
Conclusions: This study showed that SU care reduces fatality rates and improves functional outcomes, which indicates the need to implement more SUs in Korea.
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KEYWORD
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Stroke unit, Outcome, Mortality, Stroke
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