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Collaborative systematic review of the randomised trials of organised inpatient (stroke unit) care after stroke

^a Stroke Unit Trialists' Collaboration

Correspondence to: Dr Peter Langhorne, Academic Section of Geriatric Medicine, Royal Infirmary, Glasgow G4 0SF

Objectives: To define the characteristics and determine the effectiveness of organised inpatient (stroke unit) care compared with conventional care in reducing death, dependency, and the requirement for long term institutional care after stroke.
Design: Systematic review of all randomised trials which compared organised inpatient stroke care with the contemporary conventional care. Specialist stroke unit interventions were defined as either a ward or team exclusively managing stroke (dedicated stroke unit) or a ward or team specialising in the management of disabling illnesses, which include stroke (mixed assessment/rehabilitation unit). Conventional care was usually provided in a general medical ward.
Setting: 19 trials (of which three had two treatment arms). 12 trials randomised a total of 2060 patients to a dedicated stroke unit or a general medical ward, six trials (647 patients) compared a mixed assessment/rehabilitation unit with a general medical ward, and four trials (542 patients) compared a dedicated stroke unit with a mixed assessment/rehabilitation unit.
Main outcome measures: Death, institutionalisation, and dependency.
Results: Organised inpatient (stroke unit) care, when compared with conventional care, was best characterised by coordinated multidisciplinary rehabilitation, programmes of education and training in stroke, and specialisation of medical and nursing staff. The stroke unit care was usually housed in a geographically discrete ward. Stroke unit care was associated with a long term (median one year follow up) reduction of death (odds ratio 0.83, 95% confidence interval 0.69 to 0.98; P<0.05) and of the combined poor outcomes of death or dependency (0.69, 0.59 to 0.82; P <0.0001) and death or institutionalisation (0.75, 0.65 to 0.87; P<0.0001). Beneficial effects were independent of patients' age, sex, or stroke severity and of variations in stroke unit organisation. Length of stay in a hospital or institution was reduced by 8% (95% confidence interval 3% to 13%) compared with conventional care but there was considerable heterogeneity of results.
Conclusions: Organised stroke unit care resulted in long term reductions in death, dependency, and the need for institutional care. The observed benefits were not restricted to any particular subgroup of patients or model of stroke unit care. No systematic increase in the use of resources (in terms of length of stay) was apparent.

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• Govan, L., Langhorne, P., Weir, C. J., for the Stroke Unit Trialists Collaboration, (2007). Does the Prevention of Complications Explain the Survival Benefit of Organized Inpatient (Stroke Unit) Care?: Further Analysis of a Systematic Review. Stroke 38: 2536-2540 [Abstract] [Full text]  
• Qureshi, A. I., Suri, M. F. K., Nasar, A., Kirmani, J. F., Ezzeddine, M. A., Divani, A. A., Giles, W. H. (2007). Changes in Cost and Outcome Among US Patients With Stroke Hospitalized in 1990 to 1991 and Those Hospitalized in 2000 to 2001. Stroke 38: 2180-2184 [Abstract] [Full text]  
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• Rastenyte, D., Sopagiene, D., Virviciute, D., Jureniene, K. (2006). Diverging trends in the incidence and mortality of stroke during the period 1986--2002: A study from the Stroke register in Kaunas, Lithuania. Scand J Public Health 34: 488-495 [Abstract]  
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• O'Connor, R. J, Neumann, V. C (2006). Payment by results or payment by outcome? The history of measuring medicine.. JRSM 99: 226-231 [Full text]  
• O'Connell, J. E., Hildreth, A. J., Gray, C. S., Garg, R., Chaudhuri, A., Dandona, P., Munschauer, F. (2006). Hyperglycemia, Insulin and Acute Ischemic Stroke. Stroke 37: 1150-1151 [Full text]  
• (2005). Part 9: Adult Stroke. Circulation 112: IV-111-IV-120 [Full text]  
• (2005). Part 9: Stroke. Circulation 112: III-110-III-104 [Full text]  
• Drummond, A. E R, Pearson, B., Lincoln, N. B, Berman, P. (2005). Ten year follow-up of a randomised controlled trial of care in a stroke rehabilitation unit. BMJ 331: 491-492 [Full text]  
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• Chamorro, A., Horcajada, J.P., Obach, V., Vargas, M., Revilla, M., Torres, F., Cervera, A., Planas, A.M., Mensa, J. (2005). The Early Systemic Prophylaxis of Infection After Stroke Study: A Randomized Clinical Trial. Stroke 36: 1495-1500 [Abstract] [Full text]  
• Freeman, J A, Hobart, J C, Playford, E D, Undy, B, Thompson, A J (2005). Evaluating neurorehabilitation: lessons from routine data collection. J. Neurol. Neurosurg. Psychiatry 76: 723-728 [Abstract] [Full text]  
• Bagley, P., Hudson, M., Forster, A., Smith, J., Young, J. (2005). A randomized trial evaluation of the Oswestry Standing Frame for patients after stroke. Clin Rehabil 19: 354-364 [Abstract]  
• Yang, Y.-R., Yen, J.-G., Wang, R.-Y., Yen, L.-L., Lieu, F.-K. (2005). Gait outcomes after additional backward walking training in patients with stroke: a randomized controlled trial. Clin Rehabil 19: 264-273 [Abstract]  
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• Schwamm, L. H., Pancioli, A., Acker, J. E. III, Goldstein, L. B., Zorowitz, R. D., Shephard, T. J., Moyer, P., Gorman, M., Johnston, S. C., Duncan, P. W., Gorelick, P., Frank, J., Stranne, S. K., Smith, R., Federspiel, W., Horton, K. B., Magnis, E., Adams, R. J. (2005). Recommendations for the Establishment of Stroke Systems of Care: Recommendations From the American Stroke Association's Task Force on the Development of Stroke Systems. Circulation 111: 1078-1091 [Full text]  
• Davidson, I., Hillier, V. F, Waters, K., Walton, T., Booth, J. (2005). A study to assess the effect of nursing interventions at the weekend for people with stroke. Clin Rehabil 19: 126-137 [Abstract]  
• Wang, R.-Y., Chen, H.-I, Chen, C.-Y., Yang, Y.-R. (2005). Efficacy of Bobath versus orthopaedic approach on impairment and function at different motor recovery stages after stroke: a randomized controlled study. Clin Rehabil 19: 155-164 [Abstract]  
• Monaghan, J, Channell, K, McDowell, D, Sharma, A K (2005). Improving patient and carer communication, multidisciplinary team working and goal-setting in stroke rehabilitation. Clin Rehabil 19: 194-199 [Abstract]  
• Flemming, K. D., Brown, R. D. Jr (2004). Secondary Prevention Strategies in Ischemic Stroke: Identification and Optimal Management of Modifiable Risk Factors. Mayo Clin Proc. 79: 1330-1340 [Abstract]  
• Pendlebury, S. T., Rothwell, P. M., Algra, A., Ariesen, M.-J., Bakac, G., Czlonkowska, A., Dachenhausen, A., Krespi, Y., Korv, J., Krolikowski, K., Kulesh, S., Michel, P., Thomassen, L., Bogousslavsky, J., Brainin, M. (2004). Underfunding of Stroke Research: A Europe-Wide Problem. Stroke 35: 2368-2371 [Abstract] [Full text]  
• Heuschmann, P. U., Kolominsky-Rabas, P. L., Misselwitz, B., Hermanek, P., Leffmann, C., Janzen, R. W. C., Rother, J., Buecker-Nott, H.-J., Berger, K., for The German Stroke Registers Study Group, (2004). Predictors of In-Hospital Mortality and Attributable Risks of Death After Ischemic Stroke: The German Stroke Registers Study Group. Arch Intern Med 164: 1761-1768 [Abstract] [Full text]  
• Fjaertoft, H., Indredavik, B., Johnsen, R., Lydersen, S. (2004). Acute stroke unit care combined with early supported discharge. Long-term effects on quality of life. A randomized controlled trial. Clin Rehabil 18: 580-586 [Abstract]  
• Cadilhac, D. A., Ibrahim, J., Pearce, D. C., Ogden, K. J., McNeill, J., Davis, S. M., Donnan, G. A., for the SCOPES Study Group, (2004). Multicenter Comparison of Processes of Care Between Stroke Units and Conventional Care Wards in Australia. Stroke 35: 1035-1040 [Abstract] [Full text]  
• Weinrich, M., Good, D. C., Reding, M., Roth, E. J., Cifu, D. X., Silver, K. H., Craik, R. L., Magaziner, J., Terrin, M., Schwartz, M., Gerber, L. (2004). Timing, Intensity, and Duration of Rehabilitation for Hip Fracture and Stroke: Report of a Workshop at the National Center for Medical Rehabilitation Research. Neurorehabil Neural Repair 18: 12-28 [Abstract]  
• Gray, C. S., Hildreth, A. J., Alberti, G. K.M.M., O'Connell, J. E. (2004). Poststroke Hyperglycemia: Natural History and Immediate Management. Stroke 35: 122-126 [Abstract] [Full text]  
• Camilo, O., Goldstein, L. B. (2003). Statewide Assessment of Hospital-Based Stroke Prevention and Treatment Services in North Carolina: Changes Over the Last 5 Years. Stroke 34: 2945-2950 [Abstract] [Full text]  
• Fjaertoft, H., Indredavik, B., Lydersen, S. (2003). Stroke Unit Care Combined With Early Supported Discharge: Long-Term Follow-Up of a Randomized Controlled Trial. Stroke 34: 2687-2691 [Abstract] [Full text]  
• Lees, K. R. (2003). Stroke Is Best Managed by a Neurologist: Battle of the Titans. Stroke 34: 2764-2765 [Full text]  
• Goldstein, L.B., Matchar, D.B., Hoff-Lindquist, J., Samsa, G.P., Horner, R.D. (2003). VA Stroke Study: Neurologist care is associated with increased testing but improved outcomes. Neurology 61: 792-796 [Abstract] [Full text]  
• Sarti, C., Stegmayr, B., Tolonen, H., Mahonen, M., Tuomilehto, J., Asplund, K. (2003). Are Changes in Mortality From Stroke Caused by Changes in Stroke Event Rates or Case Fatality?: Results From the WHO MONICA Project. Stroke 34: 1833-1840 [Abstract] [Full text]  
• McMahon, A., Irwin, P., Redehan, E. (2003). Identifying priorities for strengthening and developing the nursing contribution in a field of practice: A case study in stroke care. Journal of Research in Nursing 8: 202-211 [Abstract]  
• Adams, H. P. Jr, Adams, R. J., Brott, T., del Zoppo, G. J., Furlan, A., Goldstein, L. B., Grubb, R. L., Higashida, R., Kidwell, C., Kwiatkowski, T. G., Marler, J. R., Hademenos, G. J. (2003). Guidelines for the Early Management of Patients With Ischemic Stroke: A Scientific Statement From the Stroke Council of the American Stroke Association. Stroke 34: 1056-1083 [Full text]  
• Pessah-Rasmussen, H., Engstrom, G., Jerntorp, I., Janzon, L. (2003). Increasing Stroke Incidence and Decreasing Case Fatality, 1989-1998: A Study From the Stroke Register in Malmo, Sweden. Stroke 34: 913-918 [Abstract] [Full text]  
• Tu, J. V., Gong, Y. (2003). Trends in Treatment and Outcomes for Acute Stroke Patients in Ontario, 1992-1998. Arch Intern Med 163: 293-297 [Abstract] [Full text]  
• Wade, D T, Gage, H, Owen, C, Trend, P, Grossmith, C, Kaye, J (2003). Multidisciplinary rehabilitation for people with Parkinson's disease: a randomised controlled study. J. Neurol. Neurosurg. Psychiatry 74: 158-162 [Abstract] [Full text]  
• Sulter, G., Elting, J. W., Langedijk, M., Maurits, N. M., De Keyser, J. (2003). Admitting Acute Ischemic Stroke Patients to a Stroke Care Monitoring Unit Versus a Conventional Stroke Unit: A Randomized Pilot Study. Stroke 34: 101-104 [Abstract] [Full text]  
• Wattigney, W. A., Croft, J. B., Mensah, G. A., Alberts, M. J., Shephard, T. J., Gorelick, P. B., Nilasena, D. S., Hess, D. C., Walker, M. D., Hanley, D. F. Jr, Shwayder, P., Girgus, M., Neff, L. J., Williams, J. E., LaBarthe, D. R., Collins, J. L. (2003). Establishing Data Elements for the Paul Coverdell National Acute Stroke Registry: Part 1: Proceedings of an Expert Panel. Stroke 34: 151-156 [Abstract] [Full text]  
• van den Bos, G A M, Smits, J P J M, Westert, G P, van Straten, A (2002). Socioeconomic variations in the course of stroke: unequal health outcomes, equal care?. J. Epidemiol. Community Health 56: 943-948 [Abstract] [Full text]  
• Johansen-Berg, H., Dawes, H., Guy, C., Smith, S. M., Wade, D. T., Matthews, P. M. (2002). Correlation between motor improvements and altered fMRI activity after rehabilitative therapy. Brain 125: 2731-2742 [Abstract] [Full text]  
• Hill, M. D. (2002). Hip-fracture and stroke care: parallel problems in evidence. CMAJ 167: 845-846 [Full text]  
• Hill, M. D. (2002). Stroke units in Canada. CMAJ 167: 649-650 [Full text]  
• Caplan, L. R. (2002). Treatment of Patients With Stroke. Arch Neurol 59: 703-707 [Full text]  
• Ruland, S., Gorelick, P. B., Schneck, M., Kim, D., Moore, C. G., Leurgans, S., Bhardwaj, A. (2002). Acute Stroke Care in Illinois: A Statewide Assessment of Diagnostic and Treatment Capabilities * Editorial Comment: A Statewide Assessment of Diagnostic and Treatment Capabilities. Stroke 33: 1334-1340 [Abstract] [Full text]  
• Stavem, K., Ronning, O.M. (2002). Survival of unselected stroke patients in a stroke unit compared with conventional care. QJM 95: 143-152 [Abstract] [Full text]  
• Pettersen, R., Dahl, T., Wyller, T. B. (2002). Prediction of long-term functional outcome after stroke rehabilitation. Clin Rehabil 16: 149-159 [Abstract]  
• Hackett, M. L., Vandal, A. C., Anderson, C. S., Rubenach, S. E. (2002). Long-Term Outcome in Stroke Patients and Caregivers Following Accelerated Hospital Discharge and Home-Based Rehabilitation. Stroke 33: 643-645 [Full text]  
• Fang, J., Alderman, M. H., Tu, J. V. (2001). Trend of Stroke Hospitalization, United States, 1988-1997 Editorial Comment. Stroke 32: 2221-2226 [Abstract] [Full text]  
• Rudd, A G, Lowe, D, Irwin, P, Rutledge, Z, Pearson, M (2001). National stroke audit: a tool for change?. Qual Saf Health Care 10: 141-151 [Abstract] [Full text]  
• Grieve, R., Hutton, J., Bhalla, A., Rastenyte, D., Ryglewicz, D., Sarti, C., Lamassa, M., Giroud, M., Dundas, R., Wolfe, C.D.A. (2001). A Comparison of the Costs and Survival of Hospital-Admitted Stroke Patients Across Europe. Stroke 32: 1684-1691 [Abstract] [Full text]  
• Wilson, E., Taylor, G., Phillips, S., Stewart, P. J., Dickinson, G., Ramsden, V. R., Teasell, R. W., Mayo, N., Tu, J., Elson, S., Strauss, B. (2001). Creating a Canadian stroke system. CMAJ 164: 1853-1855 [Full text]  
• Weir, N. U., Sandercock, P. A. G., Lewis, S. C., Signorini, D. F., Warlow, C. P. (2001). Variations Between Countries in Outcome After Stroke in the International Stroke Trial (IST). Stroke 32: 1370-1377 [Abstract] [Full text]  
• Weir, N., Dennis, M. S. (2001). Towards a National System for Monitoring the Quality of Hospital-Based Stroke Services. Stroke 32: 1415-1421 [Abstract] [Full text]  
• Pomeroy, V M, Evans, B, Falconer, M, Jones, D, Hill, E, Giakas, G (2001). An exploration of the effects of weighted garments on balance and gait of stroke patients with residual disability. Clin Rehabil 15: 390-397 [Abstract]  
• Handschu, R., Garling, A., Heuschmann, P. U., Kolominsky-Rabas, P. L., Erbguth, F., Neundorfer, B. (2001). Acute Stroke Management in the Local General Hospital. Stroke 32: 866-870 [Abstract] [Full text]  
• Muir, K. W (2001). MEDICAL MANAGEMENT OF STROKE. J. Neurol. Neurosurg. Psychiatry 70: 12i-16 [Full text]  
• Bhalla, A., Wolfe, C.D.A., Rudd, A.G. (2001). Management of acute physiological parameters after stroke. QJM 94: 167-172 [Abstract] [Full text]  
• Wade, D. T (2001). Research into rehabilitation. What is the priority?. Clin Rehabil 15: 229-232 [Abstract]  
• Lennon, S. (2001). Gait Re-education Based on the Bobath Concept in Two Patients With Hemiplegia Following Stroke. ptjournal 81: 924-935 [Abstract] [Full text]  
• Lees, K. R., Dyker, A. G., Sharma, A., Ford, G. A., Ardron, M. E., Grosset, D. G. (2001). Tolerability of the Low-Affinity, Use-Dependent NMDA Antagonist AR-R15896AR in Stroke Patients : A Dose-Ranging Study. Stroke 32: 466-472 [Abstract] [Full text]  
• , S. (2001). Recent advances: Geriatric. BMJ 322: 86-89 [Full text]  
• Smith, J., Brotheridge, S., Young, J. (2001). Patterns of hemiparesis recovery in lacunar and partial anterior circulation infarct stroke syndromes. Clin Rehabil 15: 59-66 [Abstract]  
• Caro, J. J., Huybrechts, K. F., Kelley, H. E. (2001). Predicting Treatment Costs After Acute Ischemic Stroke on the Basis of Patient Characteristics at Presentation and Early Dysfunction. Stroke 32: 100-106 [Abstract] [Full text]  
• Langhorne, P., Duncan, P. (2001). Does the Organization of Postacute Stroke Care Really Matter?. Stroke 32: 268-274 [Abstract] [Full text]  
• Gubitz, G., Sandercock, P. (2000). Regular review: Prevention of ischaemic stroke. BMJ 321: 1455-1459 [Full text]  
• Freeman, J A, Thompson, A J (2000). Community services in multiple sclerosis: still a matter of chance. J. Neurol. Neurosurg. Psychiatry 69: 728-732 [Abstract] [Full text]  
• Indredavik, B., Fjartoft, H., Ekeberg, G., Loge, A. D., Morch, B. (2000). Benefit of an Extended Stroke Unit Service With Early Supported Discharge : A Randomized, Controlled Trial. Stroke 31: 2989-2994 [Abstract] [Full text]  
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• Sinha, S., Warburton, E.A. (2000). The evolution of stroke units--towards a more intensive approach?. QJM 93: 633-638 [Full text]  
• Bhalla, A., Sankaralingam, S., Dundas, R., Swaminathan, R., Wolfe, C. D. A., Rudd, A. G. (2000). Influence of Raised Plasma Osmolality on Clinical Outcome After Acute Stroke. Stroke 31: 2043-2048 [Abstract] [Full text]  
• Slany, J., Jorgensen, H. S., DMSci, , Kammersgaard, L. P., Houth, J., Nakayama, H., Larsen, K., Olsen, T. S., Raaschou, H. O., Hubbe, P. (2000). Treatment in the Stroke Unit Response. Stroke 31 : 2266-2278 [Full text]  
• Sulch, D., Perez, I., Melbourn, A., Kalra, L. (2000). Randomized Controlled Trial of Integrated (Managed) Care Pathway for Stroke Rehabilitation. Stroke 31: 1929-1934 [Abstract] [Full text]