Stroke unit treatment -: 10-Year follow-up
Stroke unit treatment -: 10-Year follow-up
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DOI：
10.1161/01.str.30.8.1524
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发表时间：
1999-08-01
期刊：
影响因子：
8.3
通讯作者：
Håheim, LL
中科院分区：
文献类型：
--
作者：
Indredavik, B;Bakke, F;Håheim, LL
背景和目的：我们之前的研究表明，与中风患者相比，在我们的急性和康复卒中联合治疗单元（SU）治疗可改善中风发作后前5年的预后；方法：在一项随机对照试验中，110例有急性脑卒中症状和体征的患者被分配到普通病房，110例分配到普通病房，两组之间的基线特征无显著差异。10年后的结局以Barthel指数（Barthel Index）评定的居家患者比例、住院患者比例、死亡率和功能状态来衡量，其中Barthel指数≥60分为独立或部分独立，≥95分为独立。结果：10年后，随机分配到SU组的患者中有21例（19.1%）在家，随机分配到GW组的患者中有9例（8.2%）在家（P=0.0184）。住院患者死亡83例（75.5%），住院患者死亡96例（87.3%）（P=0.0082），住院患者分别为6例（5.4%）和5例（4.5%）。SU患者中有22例（20.0%）和GW患者中有9例（8.2%）的Barthel指数评分大于等于60 (P=0.0118)，大于等于95的患者分别为14例（12.7%）和6例（5.4%）（P=0.0606）。结论：这是第一次有研究表明，SU护理可以改善患者的生存和功能状态，并增加中风后10年能够在家生活的患者比例。急性和康复性脑卒中联合治疗似乎对脑卒中患者的预后有重要的长期影响。
Background and Purpose-We have previously shown that treat ment in our combined acute and rehabilitation stroke unit (SU) improves the outcome during the first 5 years after onset of stroke compared with that for stroke; patients treated in general wards (GW),The aim of the present trial was to examine the effects of SU care after 10 years of follow-up,Methods-In a randomized controlled trial, 110 patients with symptoms and signs of an acute stroke were allocated to the SU and 110 to GW, No significant differences existed in baseline characteristics between the groups. The outcome after: 10 years was measured by the proportion of patients at home, the proportion of patients in an institution, the mortality, and the functional state as assessed by the Barthel Index, in which a Barthel Index score of greater than or equal to 60 was classified as independent or partly independent and a score of greater than or equal to 95 was classified as independent.Results-After 10 years, 21 (19.1%) of the patients randomized to the SU and 9 (8.2%) of the patients randomized to the GW were at home (P=0.0184). Eighty-three (75.5%) of the patients from the SU and 96 (87.3%) of the patients from the GW were dead (P=0.0082), and 6 (5.4%) and 5 (4.5%),respectively, were in an institution (eg, nursing home; NS). Twenty-two (20.0%) of the SU patients and 9 (8.2%) of the GW patients had a Barthel Index score of greater than or equal to 60 (P=0.0118), and 14 (12.7%) and 6 (5.4%), respectively, had a score of greater than or equal to 95 (P=0.0606).Conclusions-For the first time it has been shown that SU care improves survival and functional state and increases the proportion of patients able to live at home 10 years after their stroke. Treatment in combined acute and rehabilitation SU seems to have important long-term effects on outcome for stroke patients.