Admitting acute ischemic stroke patients to a stroke care monitoring unit versus a conventional stroke unit: a randomized pilot study.
OBJECTIVE
Pathophysiological considerations and observational studies indicate that elevated body temperature, hypoxia, hypotension, and cardiac arrhythmias in the acute phase of ischemic stroke may aggravate brain damage and worsen outcome.


METHODS
Both units were organized with the same standard care and multidisciplinary approach to nursing and rehabilitation. A blinded observer assessed functional outcome at 3 months with the modified Rankin scale (mRS) and Barthel Index (BI). End points were (1) poor outcome, defined as either mRS > or =4 or BI <60 or the need for institutional care and (2) mortality.


RESULTS
Fifty-four patients meeting the inclusion criteria were randomized. The groups were well matched for baseline characteristics, stroke subtype, stroke severity, vascular risk factors, and prognostic factors. Poor outcome was seen in 7 (25.9%) patients in the SCMU group and in 13 (48.1%) in the SU group (P=0.16). Mortality was lower in the SCMU group than in the SU group (1 [3.7%] vs 7 [25.9%]; odds ratio, 0.11 [95% CI, 0.02 to 0.96], P=0.05).


CONCLUSIONS
This pilot study suggests that admission of acute stroke patients to an SCMU may reduce mortality and poor outcome. A larger trial is required to confirm these findings.
Sulter
Geert
G
Department of Neurology, Academic Hospital Groningen, Groningen, The Netherlands. g.a.sulter@neuro.azg.nl
Elting
Jan Willem
JW
Langedijk
Marc
M
Maurits
Natasha M
NM
De Keyser
Jacques
J
D000368:Aged; D002545:Brain Ischemia / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008991:Monitoring, Physiologic; D010343:Patient Admission; D010865:Pilot Projects; D011897:Random Allocation; D020521:Stroke / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D016019:Survival Analysis; D016896:Treatment Outcome