뇌졸중 집중치료실의 임상적 효용성 : 뇌졸중 집중치료실과 일반병실에서의 입원 중 치료비교

Abstract

Background : Many studies have demonstrated the usefulness of the coordinated interdisciplinary stroke unit(SU) care over conventional treatment of stroke patients on general wards(GW). Stroke is the leading cause of death in Koea. However, Managements are quite diverse by different professionals and facilities. We present how the acute SU in the Yonsei University Medical Center has been organized and operates, and also attempted to demonstrate the usefulness of SU care.

Methods : Patients who admitted to SU from December 2002 to June 2003 were subjected to analyses. As a control group, those who had admitted to GW during the same month-period of 2001~2002 were selected.

Results : During the six-month period, 149 patients admitted to SU and 152 in GW because of acute cerebral infarctions(<3 days of onset). There were no differences in the demographic characteristics except diabetes mellitus, the stroke causes, the admission and the discharge National Institute of Health Stroke Scale scores, the lengths of stay, the clinical sourses, and the in-hospital mortalities between two groups. Antithrombotics and rehabilitation therapy could be delivered early and adequately to patients who had been treated in SU. The frequency of complicatoins showed a tendency of lowering in the SU patients. Among the complications, the SU patients had less infections than the GW patients(12% versus 21%; P=0.04).

Conclusions : Findings in the present study support in part the beneficial role of the acute intermediate care unit in improving the quality of care delivered to stroke patients by providing a spatial and functional unit for organized management.