Wen-Jun Tu1,2,3, Feng Yan4, Bao-Hua Chao1, Xun-Ming Ji5,6, Longde Wang7,8. 1. The General Office of Stroke Prevention Project Committee, National Health Commission of the People's Republic of China, Beijing, China. 2. Institute of Radiation Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China. 3. Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China. 4. Department of Neurosurgery, Xuanwu Hospital Capital Medical University, Beijing, China. 5. Department of Neurosurgery, Xuanwu Hospital Capital Medical University, Beijing, China. jixm@ccmu.edu.cn. 6. , No 45, Changchun Street, Xicheng District, Beijing, 100053, China. jixm@ccmu.edu.cn. 7. The General Office of Stroke Prevention Project Committee, National Health Commission of the People's Republic of China, Beijing, China. wangld@nhfpc.gov.cn. 8. , No. 118, Guang'anmen Inner Street, Beijing, 100053, People's Republic of China. wangld@nhfpc.gov.cn.
Abstract
BACKGROUND: To assess whether stroke patients admitted to stroke units (SU) have a better short-term outcome than those treated in conventional wards (CW). METHODS: A total of 20 hospitals from 16 provinces in China were initially selected in this study. Finally, 24,090 consecutive admissions in 2013-2015 treated in CW and 21,332 consecutive entries in 2017-2019 treated in SU were included. The primary endpoint of this study was the all-cause death or dependency condition three months after admission. RESULTS: Patients in the SU group were more likely receiving thrombolytic therapy (3.9 vs 2.1%) and intravascular treatment (1.2 and 0.7%). In-hospital death were lower in the SU group than the CW group (SU vs CW: 2.93 vs 4.58% [absolute difference, - 2.28% {95% CI, - 3.32% to - 0.93%}, odd ratio {OR}, 0.72{95% CI, 0.61 to 0.82}]. Death after discharge was also lower in the SU group than the CW (SU vs CW: 5.07 vs 6.72% [absolute difference, - 2.33% {95% CI, - 3.39% to - 0.90%}, odd ratio {OR}, 0.75{95% CI, 0.68 to 0.84}]. In addition, patients who received SU care were less likely to be dead or disabled than those patients who received CW care after adjusting for other variability (SU vs CW: 36.20 vs 44.33% [absolute difference, - 11.33% {95% CI, - 15.32% to - 7.14%}, odd ratio {OR}, 0.78{95% CI, 0.80 to 0.85}]. CONCLUSIONS: Among patients with stroke, admission to a designated SU was associated with modestly lower mortality at discharge, reduced probability of death, or being disabled at the end of follow-up.
BACKGROUND: To assess whether strokepatients admitted to stroke units (SU) have a better short-term outcome than those treated in conventional wards (CW). METHODS: A total of 20 hospitals from 16 provinces in China were initially selected in this study. Finally, 24,090 consecutive admissions in 2013-2015 treated in CW and 21,332 consecutive entries in 2017-2019 treated in SU were included. The primary endpoint of this study was the all-cause death or dependency condition three months after admission. RESULTS:Patients in the SU group were more likely receiving thrombolytic therapy (3.9 vs 2.1%) and intravascular treatment (1.2 and 0.7%). In-hospital death were lower in the SU group than the CW group (SU vs CW: 2.93 vs 4.58% [absolute difference, - 2.28% {95% CI, - 3.32% to - 0.93%}, odd ratio {OR}, 0.72{95% CI, 0.61 to 0.82}]. Death after discharge was also lower in the SU group than the CW (SU vs CW: 5.07 vs 6.72% [absolute difference, - 2.33% {95% CI, - 3.39% to - 0.90%}, odd ratio {OR}, 0.75{95% CI, 0.68 to 0.84}]. In addition, patients who received SU care were less likely to be dead or disabled than those patients who received CW care after adjusting for other variability (SU vs CW: 36.20 vs 44.33% [absolute difference, - 11.33% {95% CI, - 15.32% to - 7.14%}, odd ratio {OR}, 0.78{95% CI, 0.80 to 0.85}]. CONCLUSIONS: Among patients with stroke, admission to a designated SU was associated with modestly lower mortality at discharge, reduced probability of death, or being disabled at the end of follow-up.
Entities:
Keywords:
China; Prognosis; Stroke; Stroke-unit Care