title: Functional outcome of stroke and the cumulative experience of a stroke unit.
abstract: OBJECTIVE
  Patients with acute stroke are more likely to survive and achieve independence if they are treated in a stroke unit. Available information in our setting is scarce. We analyse the outcomes of our patients on the basis of cumulative experience in a stroke unit.
  
  
  METHODS
  A retrospective cohort study of patients admitted to a stroke unit. We differentiate between two groups according to the year of admission: group A (July 2007-December 2009) and group B (January 2010-December 2011), analysing early outcome based on the score on the National Institute of Health stroke scale and mortality at discharge, and medium-term outcome in terms of mortality and functional status according to the modified Rankin scale at three months.
  
  
  RESULTS
  A total 1070 patients were included. There were no differences between groups with respect to favourable outcome (68.3% vs 63.9), hospital mortality (5.1% vs 6.6%), or 90-day mortality (12.8% vs 13.1%). The percentage of patients who were independent at 90 days was greater in group B (56.3% vs 65.5%, P=.03). In the multivariate analysis adjusted for stroke subtype and fibrinolytic therapy, the association between patient independence and admission period remained present.
  
  
  CONCLUSIONS
  The probability of functional independence in our patients increased alongside accumulated experience in our stroke unit with no differences in mortality.
authors.affiliation: Unidad de Ictus, Sección de Neurología, Hospital San Pedro de Alcántara, Cáceres, España.
authors.forename: J C
authors.initials: JC
authors.lastname: Portilla-Cuenca
authors.affiliation: Equipo de Ictus, Sección de Neurología, Hospital Universitario Infanta Cristina, Badajoz, España.
authors.forename: J M
authors.initials: JM
authors.lastname: Ramírez-Moreno
authors.affiliation: Unidad de Ictus, Sección de Neurología, Hospital San Pedro de Alcántara, Cáceres, España.
authors.forename: F
authors.initials: F
authors.lastname: López-Espuela
authors.affiliation: Unidad de Ictus, Sección de Neurología, Hospital San Pedro de Alcántara, Cáceres, España.
authors.forename: R M
authors.initials: RM
authors.lastname: Romero-Sevilla
authors.affiliation: Unidad de Ictus, Sección de Neurología, Hospital San Pedro de Alcántara, Cáceres, España.
authors.forename: P E
authors.initials: PE
authors.lastname: Jiménez-Caballero
authors.affiliation: Unidad de Ictus, Sección de Neurología, Hospital San Pedro de Alcántara, Cáceres, España.
authors.forename: J A
authors.initials: JA
authors.lastname: Fermín-Marrero
authors.affiliation: Unidad de Ictus, Sección de Neurología, Hospital San Pedro de Alcántara, Cáceres, España.
authors.forename: A
authors.initials: A
authors.lastname: Falcón-García
authors.affiliation: Unidad de Ictus, Sección de Neurología, Hospital San Pedro de Alcántara, Cáceres, España.
authors.forename: G
authors.initials: G
authors.lastname: Gámez-Leyva
authors.affiliation: Servicio de Rehabilitación, Hospital San Pedro de Alcántara, Cáceres, España.
authors.forename: F
authors.initials: F
authors.lastname: Castellano-Fernández
authors.affiliation: Unidad de Ictus, Sección de Neurología, Hospital San Pedro de Alcántara, Cáceres, España.
authors.forename: M L
authors.initials: ML
authors.lastname: Calle-Escobar
authors.affiliation: Unidad de Ictus, Sección de Neurología, Hospital San Pedro de Alcántara, Cáceres, España.
authors.forename: T
authors.initials: T
authors.lastname: Gavilán-Iglesias
authors.affiliation: Unidad de Ictus, Sección de Neurología, Hospital San Pedro de Alcántara, Cáceres, España.
authors.forename: M
authors.initials: M
authors.lastname: Gómez-Gutiérrez
authors.affiliation: Unidad de Ictus, Sección de Neurología, Hospital San Pedro de Alcántara, Cáceres, España.
authors.forename: A
authors.initials: A
authors.lastname: Serrano-Cabrera
authors.affiliation: Unidad de Ictus, Sección de Neurología, Hospital San Pedro de Alcántara, Cáceres, España. Electronic address: icasadon@gmail.com.
authors.forename: I
authors.initials: I
authors.lastname: Casado-Naranjo
mesh_terms: D000368:Aged; D005260:Female; D017052:Hospital Mortality; D006757:Hospital Units / Q000458:organization & administration; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D009462:Neurology / Q000458:organization & administration; D012189:Retrospective Studies; D020521:Stroke / Q000145:classification / Q000401:mortality / Q000628:therapy; D015912:Thrombolytic Therapy / Q000379:methods; D016896:Treatment Outcome
keywords: Complicaciones; Complications; Escala Rankin; Independence; Independencia; Mortalidad; Mortality; Outcome; Rankin scale; Situación funcional; Stroke unit; Unidad de ictus