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The role of stroke units in the subacute stage of stroke

Nature Clinical Practice Neurology volume 4, pages 480–481 (2008)Cite this article

The 'holy grail' of ischemic stroke therapy is the quick removal of the arterial occlusion to restore adequate brain perfusion. However, the therapeutic window is narrow,1 and—despite numerous efforts aimed at improving population awareness, emergency service organization, in-hospital diagnosis, and therapy—it is currently possible to use thrombolysis in but a minority of patients with ischemic stroke. The multinational Safe Implementation of Thrombolysis in Stroke (SITS) initiative aims to achieve thrombolysis for 5% of all stroke patients by 2009 (SITS 2009 @ 5% campaign). This goal will hopefully be reached, but what can we do to improve outcome for the remaining 95% of patients?

It is well known that treatment in a dedicated stroke unit has a positive effect on stroke outcome regardless of patient age, sex or stroke severity. The results of a recent meta-analysis conducted by the Stroke Unit Trialists' Collaboration (SUTC) confirmed that admission to a stroke unit, as opposed to a less specialized service, raised the chances of a patient with stroke surviving, regaining independence and returning home.2 Indeed, admission to a stroke unit reduced the odds of death (odds ratio [OR] 0.86, 95% CI 0.76–0.98; P = 0.02), death or institutionalized care (OR 0.82, 95% CI 0.73–0.92; P = 0.0006), and death or dependency (OR 0.82, 95% CI 0.73–0.92; P = 0.001), after median follow-up of 1 year.2

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Authors and Affiliations

  1. GL Lenzi is Professor and Chair of Neurology and V Di Piero is Professor of Neurology at Sapienza University in Rome, Italy,

    Gian Luigi Lenzi & Vittorio Di Piero

  2. V Di Piero is also President of the Italian Society of Stroke Studies.,

    Vittorio Di Piero

Authors
  1. Gian Luigi Lenzi
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  2. Vittorio Di Piero
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Correspondence to Gian Luigi Lenzi.

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The authors declare no competing financial interests.

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Lenzi, G., Di Piero, V. The role of stroke units in the subacute stage of stroke. Nat Rev Neurol 4, 480–481 (2008). https://doi.org/10.1038/ncpneuro0855

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