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Special Stroke Units May Have Better Outcomes

Fewer patients died or were disabled after stroke-unit treatment than conventional ward care

FRIDAY, Jan. 26 (HealthDay News) -- Acute stroke patients treated in specialized hospital stroke units have a lower risk of death or disability than patients treated in conventional wards, researchers report in the Jan. 27 issue of The Lancet.

Livia Candelise, M.D., of the Universita degli Studi di Milano, Italy, and colleagues compared outcomes of 4,936 patients hospitalized in stroke units within 48 hours of an acute stroke versus 6,636 patients treated in conventional wards in 260 Italian hospitals between 2000 and 2004.

The researchers found that 1,576 patients died in the hospital; 2,169 died within two years; 347 eluded follow-up. For all ages and clinical problems except unconsciousness, stroke-unit care was linked to significantly lower death and disability after two years compared with conventional care (odds ratio, 0.81).

"Admission to a stroke-unit ward with dedicated beds and staff within 48 hours of onset should be recommended for all patients with acute stroke," the authors write.

In an accompanying comment, Peter M. Rothwell, of the University of Oxford in the U.K., cautions that "similar observational studies of care in stroke units versus care in general medical wards in countries with more stroke units have produced conflicting results."

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