Stroke unit in a major medical clinic: one-year results and perspectives

Background: For patients with cerebral ischemia treatment on specialized stroke units is helpful. Details concerning organisation,diagnostic and therapy are discussed controversially. We report about a concept and the one-year results on a stroke unit in a major medical clinic. Methods: The unit consists of four beds and is organisationally attached to the intensive care unit. Immediate diagnosis allows an early etiologic classification. Management of main cofactors (hypertension, heart rate, blood glucose, temperature) are regarded important. Neurologic and neuroradiologic expertise are available at any time. Patients are taken care of by specially trained staff (nursing/medical care, physiotherapy, ergotherapy, logopedics). Results: Within a year(1.101999-30.9.2000) 340 patients with cerebral ischemia were treated in our stroke unit (152 men, 188 women, median age 75 Wears). Approximately 60% of the patients were admitted within 6 hours after the event. The Rankin-Scale was improved from 4 to 1, the Barthel-lndex from 50 to 90. Over 60% of the patients were discharged home, 20% were transferred to a rehabilitation unit, 5% into a nursing home, 6% died. 5 patients with carotid stenosis underwent surgical treatment. Conclusion: Effective diagnosis and treatment of stroke is achievable under certain qualified conditions in a medical clinic and is indispensable for sufficient care.