Elsevier

The Lancet

Volume 342, Issue 8868, 14 August 1993, Pages 395-398
The Lancet

Articles
Do stroke units save lives?

https://doi.org/10.1016/0140-6736(93)92813-9Get rights and content

Abstract

Management of stroke patients in specialist stroke units hastens recovery but is not believed to influence mortality. We did a statistical overview of randomised controlled trials reported between 1962 and 1993 in which the management of stroke patients in a specialist unit was compared with that in general wards. We identified 10 trials, 8 of which used a strict randomisation procedure. 1586 stroke patients were included; 766 were allocated to a stroke unit and 820 to general wards. The odds ratio (stroke unit vs general wards) for mortality within the first 4 months (median follow-up 3 months) after the stroke was 0·72 (95% Cl 0·56-0·92), consistent with a reduction in mortality of 28% (2p < 0·01). This reduction persisted (odds ratio 0·79, 95% Cl 0·63-0·99, 2p<0 05) when calculated for mortality during the first 12 months. The findings were not significantly altered if the analysis was limited to studies that used a formal randomisation procedure. We conclude that management of stroke patients in a stroke unit is associated with a sustained reduction in mortality.

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