Treatment and rehabilitation on a stroke unit improves 5-year survival : A community-based study

We have previously reported a marked reduction in mortality up to 1 year after treatment and rehabilitation on a stroke unit versus on general neurological and medical wards in unselected stroke patients. In the present study we wanted to test the hypothesis that this mortality-reducing effect is no...

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Bibliographic Details
Published in:Stroke (1970) 1999-05, Vol.30 (5), p.930-933
Main Authors: JØRGENSEN, H. S, KAMMERSGAARD, L. P, NAKAYAMA, H, RAASCHOU, H. O, LARSEN, K, HÜBBE, P, OLSEN, T. S
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Biological and medical sciences
Cerebrovascular Disorders - mortality
Cerebrovascular Disorders - rehabilitation
Cerebrovascular Disorders - therapy
Denmark - epidemiology
Female
Hospital Units
Hospitals, Urban
Humans
Male
Medical sciences
Middle Aged
Multivariate Analysis
Neurology
Severity of Illness Index
Survival Analysis
Vascular diseases and vascular malformations of the nervous system
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Summary:We have previously reported a marked reduction in mortality up to 1 year after treatment and rehabilitation on a stroke unit versus on general neurological and medical wards in unselected stroke patients. In the present study we wanted to test the hypothesis that this mortality-reducing effect is not temporary but is long lasting. We performed a community-based comparison of outcome in 1241 stroke patients from 2 adjacent communities in Copenhagen: in one (Frederiksberg), treatment and rehabilitation were provided on general neurological and medical wards, and in the other (Bispebjerg), treatment and rehabilitation were provided on a single large stroke unit. The 2 stroke populations were comparable regarding age, sex, initial stroke severity, lesion diameter on CT, and stroke subtype (hemorrhage/infarct), but patients treated on the stroke unit had a higher frequency of comorbidity and lower incomes. One-year mortality was 39% (general wards) versus 32% (stroke unit) (P=0.01). This difference was still present 5 years after stroke (71% versus 64%; P=0.02). In a multiple logistic regression model of 5-year mortality, treatment on a stroke unit reduced the relative risk of death by 40% (odds ratio, 0.60; 95% CI, 0.42 to 0.85; P
ISSN:0039-2499
1524-4628
DOI:10.1161/01.STR.30.5.930