Study comparing the stroke unit outcome and conventional ward treatment - A randomized study in Joinville, Brazil

Background and Purpose: To assess the impact of a stroke unit (SU) on acute phase treatment when compared to a conventional general ward treatment (GW). Method: Seventy-four patients with acute stroke were randomized between a SU and conventional general ward (GW). We compared both groups regarding the length of hospital stay, lethality and functional and clinical status within 6 months, using the Scandinavian scale and Barthel index. Results: Thirty-five and thirty-nine patients were allocated at SU and GW, respectively. Lethality on the 10th day at SU and GW achieved 8.5% and 12.8% respectively (p = 0.41), whereas 30-days mortality rates achieved 14.2% and 28.2% (p = 0.24), 17.4% and 28.7% on the 3rd month (p = 0.39), and 25.7% and 30.7% on the 6th month (p = 0.41). Thirty-day survival curve achieved 1.8 log rank (p = 0.17), with a trend for lower lethality in the SU. In order to save one death in 6 months in SU, NNT (the number need to treat) was 20; to get one more home independent patient NNT was 15. No significant difference was found between the length of hospital stay and morbidity. Conclusion: No significant benefit was found in SU patients compared to GW group. However, an evident benefit in absolute numbers was observed in lethality, survival curve and NNT in thirty days period after stroke. Further collaborative studies or incresead number of patients are required to define the role of SU.