[Characterization of medical and neurological care of stroke patients. An analysis of the data from the project, "Safeguarding Quality in Stroke Care," of the Regional Medical Council of Baden-Württemberg].
OBJECTIVE
Patients with stroke are treated in either medical or neurological units. This study investigated whether the two cohorts differ regarding their demographic composition, previous diseases, severity of the stroke and comorbidity.


METHODS
Data were collected prospectively on 2890 patients with acute stroke (50.2 % males, 49.8 % females) admitted to medical or stroke units of hospitals in Baden-Württemberg.


RESULTS
The mean age of patients treated on a medical ward was significantly higher (77 vs. 71 years). They also had significantly higher, age-related incidence of pre-existing disease (Ranking scale) and of previous cerebral episodes (32.9 % vs. 19.1 %). They had a higher incidence of atrial fibrillation (27.6 % vs. 20.5 %) and treated diabetes mellitus (31.5 % vs. 25.4 %) Various neurological deficits were also significantly more pronounced: abnormal awareness (42.4 % vs. 26.7 %), level of consciousness (29.3% vs. 12.8%), swallowing (20.3 % vs. 10.8 %), speaking (40.0 % vs. 31.5%) and speech (20.3% vs. 10.8 %) and transitory ischaemic attacks (21.2 % vs. 25.5 %). Rankin scale and Barthel index differed similarly. The patients treated in medical wards remained in hospital significantly longer (14.9 % vs. 13.9 %) and they had a higher death rate (10.6 % vs. 5.6 %) and were more disabled.


CONCLUSIONS
Patients after an acute stroke treated in medical wards differ significantly from those in stroke units by being older. Previous diseases and acute neurological deficits are more common, independent of age, and they are more disabled at discharge.
Habscheid
W
W
Medizinische Klinik, Paracelsus-Krankenhaus Ruit, Ostfildern. wolfgang.habscheid@t-online.de
Felsenstein
M
M
Pullwitt
A
A
D000208:Acute Disease; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D015897:Comorbidity; D006233:Persons with Disabilities; D005260:Female; D005858:Germany; D006757:Hospital Units; D006801:Humans; D015994:Incidence; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D011446:Prospective Studies; D012720:Severity of Illness Index; D020521:Stroke / Q000150:complications / Q000628:therapy*; D000071939:Stroke Rehabilitation
Charakterisierung internistisch und neurologsich versorgter Schlaganfallpatienten. Eine Analyse der Daten des Projektes "Qualitätssicherung in der Schlaganfallversorgung" der Landesärztekammer Baden Württemberg.