Effects of Stroke Unit Care in Acute Ischemic Stroke Patient Ineligible for Thrombolytic Treatment
Rajborirug, K.; Tumviriyakul, H.; Suwanno, J.
Journal of the Medical Association of Thailand 100(4): 410-417
2017
ISSN/ISBN: 0125-2208 PMID: 29911837 Document Number: 17296
Several trials have verified the benefits of stroke unit (SU) in acute stroke care worldwide. Compare clinical outcomes and costs of care in acute ischemic stroke patients who were ineligible for thrombolytic treatment (recombinant tissue plasminogen activator-rt PA) in a primary stroke center. A prospective study was conducted in acute ischemic stroke patients, aged 15 years old and above, There were 1,110 acute ischemic stroke patients, 472 subjects (42.52%) in general medical ward (GMW), and 638 subjects (57.48%) in stroke unit (SU). The number of neurological (brain edema, hemorrhagic transformation, or recurrent stroke), and medical complications (gastrointestinal hemorrhage, pneumonia, or pressure sore) in GMW had highly statistical significance (p<0.001, p<0.001) more than those in SU, with adjusted OR (aOR) (95% CI) of 84.53 (31.14 to 229.46), 4.03 (1.99 to 8.17), respectively. Whereas, the death rate, NIHSS, and disability (Barthel Index of ADLs, and mRS) were statistically significant lower among SU cases (p = 0.05, p<0.001, p<0.001) respectively. The median length of stay was three days in both groups, while the median cost of in hospital care was 10,206 Thai Bahts in SU, which was 15.23% higher (p<0.001). The stroke unit increases the survival rate among stroke patient compared with the general medical ward and
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