DO STROKE UNITS SAVE LIVES
DO STROKE UNITS SAVE LIVES
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DOI：
10.1016/0140-6736(93)92813-9
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发表时间：
1993-08-14
期刊：
影响因子：
168.9
通讯作者：
HOWIE, K
中科院分区：
文献类型：
--
作者：
LANGHORNE, P;WILLIAMS, BO;HOWIE, K
在中风专科病房对中风患者进行管理可以加速康复，但据信不会影响死亡率。我们对1962至1993年间报道的随机对照试验进行了统计概述，在这些试验中，中风患者在专科病房的管理与普通病房的管理进行了比较。我们确定了10项试验，其中8项使用了严格的随机程序。纳入1586名中风患者；766名被分配到卒中病房，820名被分配到普通病房。卒中后前4个月(中位随访3个月)内死亡率的优势比(卒中单位与普通病房)为0.72(95%可信区间0.56-0.92)，与死亡率降低28%(2p<；0.01)一致。当计算前12个月的死亡率时，这种下降持续存在(优势比0.79，95%可信区间0.63-0.99，2p<；0.05)。如果分析仅限于使用正式随机程序的研究，结果没有明显改变。我们得出结论，在卒中单元中管理中风患者与持续降低死亡率有关。
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% CI 0.56-0.92), consistent with a reduction in mortality of 28% (2p < 0.01). This reduction persisted (odds ratio 0.79, 95% CI 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.