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Differences in Long-Term Outcome Between Patients Treated in Stroke Units and in General Wards: A 2-Year Follow-Up of Stroke Patients in Sweden
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
National Board of Health and Welfare, Stockholm, Sweden.
Department of Medicine, Enköping Hospital, Enköping, Sweden.
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2001 (English)In: Stroke, ISSN 0039-2499, E-ISSN 1524-4628, Vol. 32, 2124-2130 p.Article in journal (Refereed) Published
Abstract [en]

Background and Purpose— The long-term beneficial effects of stroke unit care have been proved in several randomized trials. However, there is a question of large-scale applicability in routine clinical practice of interventions used by dedicated investigators in small randomized trials. The objective of this study was to compare, 21/2 years after stroke, patients who had been treated in stroke units and those treated in general wards in routine clinical practice.

Methods— This is a prospective cohort study based on 8194 patients who were included, during the first 6 months in 1997, in Riks-Stroke, the Swedish National Register for quality assessment of acute stroke. Two years after the event, 5189 patients were still alive and 5104 were followed up with a postal questionnaire to which 4038 responded.

Results— Among the group of patients who were independent in activities of daily living (ADL) functions before the stroke, patients who were treated in stroke units were less often dependent in ADL functions, after adjustment for case mix (OR, 0.79; CI, 0.66 to 0.94). If they also lived at home before the stroke, then they had a lower case-fatality rate 2 years after the stroke (OR, 0.81; CI, 0.72 to 0.92).

Conclusions— Long-term beneficial effects of treatment in stroke units were shown for patients who were independent in ADL functions before the stroke. No benefits were shown for patients who were dependent on help for primary ADL before the stroke. Further studies on this group of patients with more detailed outcome measures are needed.

Place, publisher, year, edition, pages
American Heart Association, Inc. , 2001. Vol. 32, 2124-2130 p.
Keyword [en]
follow-up studies, stroke management, stroke outcome, stroke units, Sweden
National Category
Clinical Medicine
Identifiers
URN: urn:nbn:se:umu:diva-94816DOI: 10.1161/hs0901.095724OAI: oai:DiVA.org:umu-94816DiVA: diva2:756439
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digitalisering@umu
Available from: 2014-10-17 Created: 2014-10-17 Last updated: 2017-12-05Bibliographically approved
In thesis
1. Stroke care in Sweden: Hospital care and patient follow-up based on Riks-Stroke, the National Quality Register for Stroke Care
Open this publication in new window or tab >>Stroke care in Sweden: Hospital care and patient follow-up based on Riks-Stroke, the National Quality Register for Stroke Care
2003 (English)Doctoral thesis, comprehensive summary (Other academic)
Place, publisher, year, edition, pages
Umeå: Umeå Universitet, 2003. 92 p.
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 838
Keyword
stroke care, quality register, routine clinical practice, validation, sex differences, stroke units, atrial fibrillation, oral anticoagulants, post-stroke fatigue
National Category
Clinical Medicine
Identifiers
urn:nbn:se:umu:diva-94114 (URN)91-7305-426-7 (ISBN)
Public defence
2003-05-28, Tandläkarhögskolan, sal B, 9 trp., Umeå universitet, Umeå, 13:00
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digitalisering@umu
Note

Diss. (sammanfattning) Umeå : Umeå universitet, 2003

Available from: 2014-10-17 Created: 2014-10-03 Last updated: 2015-04-08Bibliographically approved

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Glader, Eva-LottaStegmayr, Birgitta

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