급성 뇌경색 환자에서 뇌졸중치료실과 일반병동 치료 후 사망률과 의존성의 차이 = Differences of Mortality and Dependence Between Stroke Unit and General Ward Care in Acute Ischemic Stroke Patients

다국어 초록 (Multilingual Abstract)

Background: There is strong evidence for the efficacy of stroke unit (SU) care, which has become a common practice in
other developed countries but is available only in a small number of centers in Korea. This late introduction of SU care in
Korea can be at least partly attributed to doubts about its benefits on patient outcomes compared to general ward (GW)
care in our routine practice.
Methods: Based on a prospective stroke registry, we identified 1,300 acute stroke patients hospitalized in either SUs
(n=195) or GWs (n=1,105) from January 2004 to June 2008. Clinical outcomes such as fatality and disability rates were
compared using propensity score matching in the total cohort. Additional statistical adjustments were performed using
stepwise logistic regression analyses with the backward elimination method for potential confounders.
Results: The baseline characteristics did not differ significantly between patients admitted to SUs (n=195) and their
matched controls (n=386). The 3-month dependency rate was 17.4% in SUs and 21.0% in GWs (p=0.31), and the case
fatality rates were 1.5% and 8.0% (p<0.001), respectively. Adjusted odds ratios for SU care were 0.49 for dependency (95%
confidence interval [CI]=0.22-1.08) and 0.17 for death (95% CI=0.04-0.83).
Conclusions: This study showed that SU care reduces fatality rates and improves functional outcomes, which indicates
the need to implement more SUs in Korea.

다국어 초록 (Multilingual Abstract)

Background: There is strong evidence for the efficacy of stroke unit (SU) care, which has become a common practice in
other developed countries but is available only in a small number of centers in Korea. This late introduction of SU care in
Korea can be at least partly attributed to doubts about its benefits on patient outcomes compared to general ward (GW)
care in our routine practice.
Methods: Based on a prospective stroke registry, we identified 1,300 acute stroke patients hospitalized in either SUs
(n=195) or GWs (n=1,105) from January 2004 to June 2008. Clinical outcomes such as fatality and disability rates were
compared using propensity score matching in the total cohort. Additional statistical adjustments were performed using
stepwise logistic regression analyses with the backward elimination method for potential confounders.
Results: The baseline characteristics did not differ significantly between patients admitted to SUs (n=195) and their
matched controls (n=386). The 3-month dependency rate was 17.4% in SUs and 21.0% in GWs (p=0.31), and the case
fatality rates were 1.5% and 8.0% (p<0.001), respectively. Adjusted odds ratios for SU care were 0.49 for dependency (95%
confidence interval [CI]=0.22-1.08) and 0.17 for death (95% CI=0.04-0.83).
Conclusions: This study showed that SU care reduces fatality rates and improves functional outcomes, which indicates
the need to implement more SUs in Korea.

참고문헌 (Reference)

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