[article] Efficacy of acute stroke units : Updated meta-analysis [printed text] / Ömer R. Saka, Author ; Ying Sun, Author ; D Michiels, Author ; Vincent Thijs, Author ; Dimitri Hemelsoet, Author ; Marijke Eyssen  , Author ; Dominique Paulus , Author ; Johan Maervoet, Author . - 2013 . - 824. Languages : English ( eng) in Cerebrovascular Diseases > 35(2013)Suppl.3 [05/01/2013] . - 824
| Descriptors: |
Classification
W 1 Serials. Periodicals
Indexation
2011-20 ; Belgium ; Journal Article ; Peer Review ; R181 ; Randomized Controlled Trials ; Stroke
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| Abstract: |
Background A Cochrane review (2009) has concluded that the provision of care in stroke units (SU) improves stroke outcomes significantly. This study aimed to update the Cochrane review on acute SU care. We performed a meta-analysis on the benefit of acute SUs against alternatives. Methods Clinical trials published before 2006 were identified via the Cochrane review. Trials after 2006 were identified through a thorough electronic database search. For meta-analysis dichotomous outcomes were estimated by odds ratio (OR) and continuous outcomes were estimated by standardized mean difference. Weight of a study was calculated based on inverse variance. Results After two screenings 20 trials were included in the study: 12 compared SUs with alternative, 5 compared SUs with a specific protocol versus conventional SU care, 3 compared SUs followed by specific interventions versus SUs followed by conventional follow-up. Acute SU care significantly improved patient outcomes in terms of institutional care (OR=0.61, 95% confidence interval (CI) 0.47 to 0.79, P=0.0002); death or institutional care (OR=0.70, 95% CI 0.60 to 0.83, P<0.0001), death or dependency (OR=0.81, 95% CI 0.69 to 0.96, P=0.01; (4) length of hospital stay, standardized mean difference=-0.27 day, 95% CI -0.36 to -0.19, P<0.0001). The effect of SUs on mortality was around bottom-line statistical significance (OR=0.84, 95% CI 0.71 to 1.00, P=0.05). The benefit of SUs on mortality can be easily altered by changing the inclusion criteria (e.g. randomized controlled trials only, use of unpublished data). Effect of SUs on dependency was not significant (OR=0.92, 95% CI 0.74 to 1.13, P= 0.42). Conclusion This update confirmed the findings of the previous Cochrane review in general. Yet it showed that the benefit of SUs was more significant on composite outcomes (e.g. death or dependency, death or institutional care) than on individual outcomes (e.g. death, dependency). |
| Link for e-copy: |
http://dx.doi.org/10.1159/000353129 |
| Format of e-copy: |
PDF [Requires Subscription] |
| Record link: |
https://kce.docressources.info/index.php?lvl=notice_display&id=3780 |
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Add the result to your basket Make a suggestion Refine your search Apply to external sourcesAccreditation in stroke units of 6 European regions in Cerebrovascular Diseases, 35(2013)Suppl.3 ([05/01/2013])
Endovasculaire behandeling van Carotisstenose / Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre (2005)
