• W Habscheid, M Felsenstein, and A Pullwitt.
• Medizinische Klinik, Paracelsus-Krankenhaus Ruit, Ostfildern. wolfgang.habscheid@t-online.de
• Dtsch. Med. Wochenschr. 2004 Sep 10; 129 (37): 191119151911-5.

Background And ObjectivePatients with stroke are treated in either medical or neurological units. This study investigated whether the two cohorts differ regarding their demographic composition, previous diseases, severity of the stroke and comorbidity.Patients And MethodsData were collected prospectively on 2890 patients with acute stroke (50.2 % males, 49.8 % females) admitted to medical or stroke units of hospitals in Baden-Württemberg.ResultsThe mean age of patients treated on a medical ward was significantly higher (77 vs. 71 years). They also had significantly higher, age-related incidence of pre-existing disease (Ranking scale) and of previous cerebral episodes (32.9 % vs. 19.1 %). They had a higher incidence of atrial fibrillation (27.6 % vs. 20.5 %) and treated diabetes mellitus (31.5 % vs. 25.4 %) Various neurological deficits were also significantly more pronounced: abnormal awareness (42.4 % vs. 26.7 %), level of consciousness (29.3% vs. 12.8%), swallowing (20.3 % vs. 10.8 %), speaking (40.0 % vs. 31.5%) and speech (20.3% vs. 10.8 %) and transitory ischaemic attacks (21.2 % vs. 25.5 %). Rankin scale and Barthel index differed similarly. The patients treated in medical wards remained in hospital significantly longer (14.9 % vs. 13.9 %) and they had a higher death rate (10.6 % vs. 5.6 %) and were more disabled.ConclusionPatients after an acute stroke treated in medical wards differ significantly from those in stroke units by being older. Previous diseases and acute neurological deficits are more common, independent of age, and they are more disabled at discharge.

23 keywords...

hide…