***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND AND PURPOSE The efficacy of stroke units has been extensively examined . It is unknown , however , whether the superiority of the stroke unit will remain after the increased focus on stroke treatment in general medicine . This study of patients admitted to the hospital early and with a short length of stay determines the effect and identifies certain important components of a stroke unit . METHODS Five hundred fifty patients aged 60 years or older with acute stroke were allocated by a quasi-r and omized design to a stroke unit or a general medical ward based on date of birth in the month . Patients admitted within 24 hours of onset were enrolled . Outcomes after 7 months were death , proportion needing long-term care , and change in neurological and functional state assessed by the Sc and inavian Stroke Scale and Barthel Index . RESULTS Seven months after admission there was a trend in favor of the stroke unit in all outcome measures , but no significant differences in clinical outcomes were found except for change in the Sc and inavian Stroke Scale score . Recurrent stroke during hospitalization occurred more often in the general medical ward ( P = .03 ) . The stroke unit was significantly more aggressive in mobilization out of bed ( P<.01 ) and use of parenteral fluid ( P<.0001 ) , aspirin ( P<.0001 ) , antipyretics ( P<.0001 ) , and antibiotics ( P<.0001 ) . CONCLUSIONS Our study confirms the benefit of the stroke unit , but the effects on the most reliable clinical outcomes were modest and insignificant . Treatment in this stroke unit hastened recovery . More aggressive rehabilitation and use of parenteral fluid , aspirin , antipyretics , and antibiotics appeared in the stroke unit In a prospect i ve controlled trial we compared the clinical outcome for unselected acute stroke patients in a non-intensive stroke unit ( n = 110 ) and in general medical wards ( n = 183 ) . The patients were comparable in age , marital state and functional impairment on admission .  Case fatality rates over the first year after the stroke were similar in the two groups . By three months after the stroke , 15 % of the survivors initially admitted to the stroke unit and 39 % of those admitted to general medical wards remained hospitalized ( p less than 0.001 ) . The corresponding figures by one year after the cerebrovascular accident were 12 % and 28 % , respectively ( p less than 0.05 ) . A greater proportion of surviving stroke unit patients was independent in walking ( 0.10 greater than p greater than 0.05 ) , personal hygiene ( p less than 0.05 ) and dressing ( p less than 0.001 ) . Essential features of the stroke unit are team work headed by a stroke nurse , staff , patient and family education and very early onset of rehabilitation . We conclude that this strategy improves functional outcome and reduces the need for long-term hospital care In a r and omized controlled trial we compared the clinical outcome of acute stroke patients , 110 of whom were allocated to treatment in a stroke unit and 110 to treatment in general medical wards .  No significant difference existed between these groups with regard to sex , age , marital status , medical history , or functional impairment on admission . Outcome was measured at 6 and 52 weeks after the stroke by the proportion of patients at home , the proportion of patients in an institution , the mortality , and the functional state . After 6 weeks 56.4 % of the patients r and omized to the stroke unit and 32.7 % of the patients r and omized to the general medical wards were at home ( p = 0.0004 ) , and after 52 weeks 62.7 % and 44.6 % , respectively , were at home ( p = 0.002 ) . After 6 weeks 36.3 % of the patients from the stroke unit and 50.0 % from the general medical wards were in an institution ( p = 0.02 ) ; after 52 weeks 12.7 % and 22.7 % , respectively , were institutionalized ( p = 0.016 ) . After 6 weeks mortality was 7.3 % for the stroke unit group and 17.3 % for the general medical wards group ( p = 0.027 ) . After 52 weeks mortality was 24.6 % for the stroke unit group and 32.7 % for the general medical wards group ( difference not significant ) . Functional state was significantly better for patients treated in the stroke unit after both 6 and 52 weeks . We conclude that care of patients with acute stroke in a stroke unit improves clinical outcome compared with treatment in general medical wards Background and Purpose The aim of the study was to compare the effect of conventional treatment with the effect of acute stroke unit care integrated with geriatric stroke unit care continuum . Methods A 1-year study was undertaken with 2:1 r and omization to stroke unit care or conventional care , with assessment by an independent team . The study was composed of 249 elderly patients ( aged ≥70 years ) hospitalized for acute stroke , without previous cerebral lesion and without recognized need of care . Main outcome measures were patients at home after 1 year , ability in daily living activities , health-related quality of life score according to question naire , death or institutional care , and death or dependence . Results One hundred two patients ( 61 % ) in the stroke unit and 49 patients ( 59 % ) in the general ward group were alive and at home after 1 year ( 95 % CI −10 % to 16 % ) . There were no significant differences in daily life activities or quality of life . In patients with concomitant cardiac disease , there was a reduction in death or institutional care after 3 months in the stroke unit group compared with the group receiving conventional care ( 28 % versus 49 % , respectively ; 95 % CI −40 % to −3 % ) . This effect did not remain after 1 year . Patients seeking care after 24 hours often had mild stroke and lived alone . Conclusions There was no effect on the number of patients living at home after 1 year , but after 3 months of stroke unit care , a beneficial effect was found on mortality and the need for institutional care among those with concomitant heart disease . This study involved patients who were considerably older than those investigated in previous r and omized studies of acute stroke unit care ; thus , these findings will contribute to the specialized register of controlled trials in stroke Background and Purpose : Few studies have assessed the influence of the organization of stroke care on health-related quality of life ( HRQoL ) . The present study compared HRQoL 6 months after stroke between subjects who had been treated in an acute stroke unit ( SU ) and those treated in general medical wards ( GMW ) . Methods : In total 550 subjects≧60 years of age with acute stroke were prospect ively allocated according to date of birth ( day of the month ) to treatment in an SU with short length of stay or GMWs . In the present study , 325 survivors at 5 days with Sc and inavian stroke scale ( SSS ) orientation score > 5 and SSS speech score > 5 were included . We assessed HRQoL with the Short Form 36 ( SF-36 ) question naire 6 months after stroke onset and estimated utility values from the SF-36 scores . Results : Of the 325 eligible subjects , 158 were allocated to an SU and 167 to GMWs . Among 296 survivors at 6 months , 115 subjects ( 79 % of survivors ) in the SU group completed the question naire and 121 ( 80 % ) in the GMW group . There was no statistically significant difference between the treatment groups on any of the 8 SF-36 scales or the 2 component summary scales . After integrating death in the comparison of HRQoL , there was still no difference in outcome between the groups . Conclusion : An acute SU with a short length of stay , offering early treatment and rehabilitation , could not show an improvement in the HRQoL of stroke patients ≧60 years 6 months after stroke compared with initial treatment in GMWs There is ample evidence from r and omized trials that for patients with stroke , stroke unit care is superior to care in general medical or neurological wards . This evidence , which has been adopted by international guidelines has to be implemented into daily stroke care . This consensus document prepared by the Belgian Stroke Council provides a set of minimum criteria to meet international st and ards for stroke care . It is intended to provide help in the creation of stroke units in centers who do not currently have one and to provide a benchmark for centres already having organised stroke care BACKGROUND AND PURPOSE To assess the impact of a stroke unit ( SU ) on acute phase treatment when compared to a conventional general ward treatment ( GW ) . METHOD Seventy-four patients with acute stroke were r and omized between a SU and conventional general ward ( GW ) . We compared both groups regarding the length of hospital stay , lethality and functional and clinical status within 6 months , using the Sc and inavian scale and Barthel index . RESULTS Thirty-five and thirty-nine patients were allocated at SU and GW , respectively . Lethality on the 10th day at SU and GW achieved 8.5 % and 12.8 % respectively ( p= 0.41 ) , whereas 30-days mortality rates achieved 14.2 % and 28.2 % ( p= 0.24 ) , 17.4 % and 28.7 % on the 3rd month ( p= 0.39 ) , and 25.7 % and 30.7 % on the 6th month ( p= 0.41 ) . Thirty-day survival curve achieved 1.8 log rank ( p= 0.17 ) , with a trend for lower lethality in the SU . In order to save one death in 6 months in SU , NNT ( the number need to treat ) was 20 ; to get one more home independent patient NNT was 15 . No significant difference was found between the length of hospital stay and morbidity . CONCLUSION No significant benefit was found in SU patients compared to GW group . However , an evident benefit in absolute numbers was observed in lethality , survival curve and NNT in thirty days period after stroke . Further collaborative studies or incresead number of patients are required to define the role of SU Follow-up of a controlled trial of the management of acute stroke in the elderly showed that the improvement in functional outcome at the time of discharge from hospital that had been achieved through establishing a stroke unit had disappeared by one year . Factors that might have contributed to this included overprotection by the families of patients who had been treated in the stroke unit , who were not permitted to carry out activities of daily living in which they were independent , and the early discharge from medical units of patients whose full rehabilitation potential had not been realised . Prolonging the benefits of short-term gains in functional outcome through the intervention of a stroke unit requires that all the links in the chain of stroke rehabilitation are maintained , including the proper orientation of patients ' families before discharge from hospital BACKGROUND Stroke unit is the most effective treatment method to benefit stroke patients . Our study is to evaluate the early effectiveness of a hospital stroke unit ( SU ) . METHODS Three hundred and ninety-two patients who had suffered from acute strokes and who were admitted to our hospital between December 2001 and January 2003 were recruited for this controlled study . All patients were sent at r and om to either the SU or the general ward ( GW ) for treatment . The following indices were measured by : Barthel Index ( BI ) , National Institute of Health Stroke Scale ( NIHSS ) , Oxford H and icap Scale ( OHS ) . RESULTS The mean change in BI score between the day of admission and the day of discharge was 20.00 + /- 24.36 for the SU group and 10.63 + /- 23.59 for the GW group . A difference that is statistically significant ( P = 0.000 ) . The mean change in NIHSS score was -2.01 + /- 6.61 for the SU group and 0.55 + /- 7.44 for the GW group . A difference that is also statistically significant ( P = 0.000 ) . Finally , the mean change in OHS score was -0.74 + /- 1.04 for the SU group and -0.28 + /- 0.98 for the GW group , also a statistically significant difference ( P = 0.000 ) . Among SU patients , patient satisfaction was higher ( P = 0.000 ) , the rehabilitation success rate was higher ( P = 0.000 ) , and there were fewer complications ( P = 0.000 ) . CONCLUSION Compared to GW patients , stroke patients treated in a special SU were able to return to normal daily activities earlier , with better social abilities , and have reduced neurological defects , without increasing the overall economic burden BACKGROUND Organised specialist care for stroke improves outcome , but the merits of different methods of organisation are in doubt . This study compares the efficacy of stroke unit with stroke team or domiciliary care . METHODS A single-blind , r and omised , controlled trial was undertaken in 457 acute-stroke patients ( average age 76 years , 48 % women ) r and omly assigned to stroke unit , general wards with stroke team support , or domiciliary stroke care , within 72 h of stroke onset . Outcome was assessed at 3 , 6 , and 12 months . The primary outcome measure was death or institutionalisation at 12 months . Analyses were by intention to treat . FINDINGS 152 patients were allocated to the stroke unit , 152 to stroke team , and 153 to domiciliary stroke care . 51 ( 34 % ) patients in the domiciliary group were admitted to hospital after r and omisation . Mortality or institutionalisation at 1 year were lower in patients on a stroke unit than for those receiving care from a stroke team ( 21/152 [ 14 % ] vs 45/149 [ 30 % ] ; p<0.001 ) or domiciliary care ( 21/152 [ 14 % ] vs 34/144 [ 24 % ] ; 
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The findings from this study were broadly in line with the original Cochrane review : acute stroke units can improve survival and independency , as well as reduce the chance of hospitalization and the length of inpatient stay .
This result could have an impact on the future dem and for healthcare services for individuals that survive a stroke but became dependent on their care-givers .