A Cochrane review [Abstract] 1 included 28 with a total of 5855 participants. Studies compared stroke unit care with an alternative service. Twenty-one trials (n=3994) compared stroke unit care with care provided in general wards. Stroke unit care showed reductions in the odds of death recorded at final (median one year) follow-up (OR 0.87, 95% CI 0.69 to 0.94; p=0.005), the odds of death or institutionalised care (OR 0.78, 95% CI 0.68 to 0.89; p=0.0003) and the odds of death or dependency (OR 0.79, 95% CI 0.68 to 0.90; p=0.0007). Sensitivity analyses indicated that the observed benefits remained when the analysis was restricted to securely randomised trials that used unequivocally blinded outcome assessment with a fixed period of follow-up. Outcomes were independent of patient age, sex, initial stroke severity or stroke type, and appeared to be better in stroke units based in a discrete ward. There was no indication that organised stroke unit care resulted in a longer hospital stay.
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