Systematic Review |
Is stroke unit care portable? A systematic review of the clinical trials
1 Academic Section of Geriatric Medicine, Level 3, Centre Block, Royal Infirmary, Glasgow G4 0SF, UK
2 Centre for Cancer Epidemiology, Kinnaird Road, Manchester, UK
3 Department of Diabetes, Endocrinology and Internal Medicine, Guy’s, King’s and St Thomas’ School of Medicine, Denmark Hill Campus, London, UK
4 School of Physical and Occupational Therapy, McGill University, Montreal, Canada
5 Afrox Rehabilitation, Afrox Healthcare Limited, Cape Town, South Africa
6 Department of Medicine and Care, Clinical Pharmacology, Faculty of Health Sciences, Linkoping University, Sweden
Address correspondence to: P. Langhorne. Fax: +44 (0)141 211 4944. Email: p.langhorne{at}clinmed.gla.ac.uk
Abstract
Background: it is not known if mobile stroke teams can achieve the good results seen in trials of geographically discrete stroke wards (stroke units).
Objective: to establish the effectiveness of mobile stroke teams.
Design: systematic review of controlled clinical trials that compared peripatetic systems of organised stroke care (stroke team care) with alternative hospital services.
Methods: systematic review and meta-analysis (using Cochrane Collaboration methodology and involving the primary trialists).Clinical outcomes included death, dependency, the need for institutional care and measures of the process of care such as the delivery of key investigations and treatments.
Results: six clinical trials (1,085 patients) were identified; five (781 patients) compared some form of stroke team care with conventional care in general medical wards and one (304 patients) compared team care with a comprehensive stroke unit.Compared with care in general wards, stroke team care improved some aspects of the process of care, but clinical outcomes were similar. Compared with a comprehensive stroke unit, stroke team patients were significantly less likely to survive (P <0.001), return home (P < 0.001) or regain independence (P < 0.0001). Most aspects of the process of care were also poorer than in the stroke unit.
Conclusions: care from a mobile stroke team had no major impact on death, dependency or the need for institutional care.
Keywords: stroke team, stroke unit, systematic review, meta-analysis, elderly
Received August 27, 2004; Revision received December 9, 2004. accepted in revised form December 9, 2004.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  G. Saposnik, J. Fang, M. O'Donnell, V. Hachinski, M. K. Kapral, M. D. Hill, and on behalf of the Investigators of the Registry of Escalating Levels of Access to In-Hospital Care and Stroke Mortality Stroke, September 1, 2008; 39(9): 2522 - 2530. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. M.T. Schouten, M. E.J.L. Hulscher, R. Akkermans, J. J.E. van Everdingen, R. P.T.M. Grol, and R. Huijsman Factors That Influence the Stroke Care Team's Effectiveness in Reducing the Length of Hospital Stay Stroke, September 1, 2008; 39(9): 2515 - 2521. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M Agar, D. Currow, J Plummer, R Chye, and B Draper Differing management of people with advanced cancer and delirium by four sub-specialties Palliative Medicine, July 1, 2008; 22(5): 633 - 640. [Abstract] [PDF]
|
|
|
|
|
|
J. Redfern, C. McKevitt, and C. D.A. Wolfe Development of Complex Interventions in Stroke Care: A Systematic Review Stroke, September 1, 2006; 37(9): 2410 - 2419. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. D.A. Wolfe, D. O.C. Corbin, N. C. Smeeton, G. H.E. Gay, A. G. Rudd, A. J. Hennis, R. J. Wilks, and H. S. Fraser Poststroke Survival for Black-Caribbean Populations in Barbados and South London Stroke, August 1, 2006; 37(8): 1991 - 1996. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W.-D. Heiss and R. W. Teasel Brain Recovery and Rehabilitation Stroke, February 1, 2006; 37(2): 314 - 316. [Full Text] [PDF]
|
|
|
|
|
|
B. Norrving and R. J. Adams Organized Stroke Care Stroke, February 1, 2006; 37(2): 326 - 328. [Full Text] [PDF]
|
|