[What characterises an effective stroke unit?].
BACKGROUND
The main goals of stroke therapy are to reduce death and functional impairment. The aim of this article is to show how stroke units can contribute to reach these goals.


METHODS
The article is based on a review of relevant literature, our own research and the experience acquired as a member of the Stroke Unit Trialists Collaboration (SUTC).


RESULTS
23 published randomised trials have documented that treatment in stroke units reduce the incidences of death and serious functional impairment and the need for nursing home care, both in the short and long term. All acute stroke patients experience a positive effect. Stroke units that offer both acute medical treatment and rehabilitation are best documented. A combined stroke unit is i) a geographically defined unit with dedicated beds, ii) staffed with multidisciplinary and specially trained personnel, and iii) has a standardised protocol for diagnostic evaluation, observation, acute treatment and rehabilitation.


CONCLUSIONS
An effective stroke unit must offer both acute medical treatment and rehabilitation. Acute stroke is best treated in a combined stroke unit. Combined stroke units with adequate capacity for all patients with acute stroke, and treatment as defined by the randomised studies, should be given first priority in Norwegian stroke care.
Indredavik
Bent
B
Avdeling for hjerneslag, Medisinsk klinikk, St. Olavs Hospital, 7006 Trondheim. bent.indredavik@ntnu.no
D002983:Clinical Competence; D019317:Evidence-Based Medicine; D006757:Hospital Units / Q000458:organization & administration / Q000592:standards; D006801:Humans; D015201:Meta-Analysis as Topic; D017063:Outcome Assessment, Health Care; D010348:Patient Care Team; D016032:Randomized Controlled Trials as Topic; D020521:Stroke / Q000175:diagnosis / Q000401:mortality; D000071939:Stroke Rehabilitation; D000078329:Workforce