***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: Caring for stroke patients in stroke units , compared with other hospital locations , leads to decreased mortality and disability at one year.1 A trial of a combined acute and rehabilitation ward in Trondheim , Norway , showed that hospital care improved survival and functional outcome at five years.2 The benefits were attributed to the treatment provided in the first few weeks after stroke . The purpose of this study was to examine the effects of care in a non-acute stroke unit on outcome at five years . The methods and findings of 315 patients at one year of our r and omised study comparing a non-acute stroke rehabilitation unit with care on conventional medical and geriatric wards  have been published.3 In the present study , we ascertained survival to five years by using hospital records and death certificates . Survivors were traced to establish their residential status and visited by a research er who was 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 BACKGROUND AND PURPOSE We have previously shown that treatment in our combined acute and rehabilitation stroke unit ( SU ) improves the outcome during the first 5 years after onset of stroke compared with that for stroke patients treated in general wards ( GW ) . The aim of the present trial was to examine the effects of SU care after 10 years of follow-up . METHODS In a r and omized controlled trial , 110 patients with symptoms and signs of an acute stroke were allocated to the SU and 110 to GW .  No significant differences existed in baseline characteristics between the groups . The outcome after 10 years was measured by the proportion of patients at home , the proportion of patients in an institution , the mortality , and the functional state as assessed by the Barthel Index , in which a Barthel Index score of > /=60 was classified as independent or partly independent and a score of > /=95 was classified as independent . RESULTS After 10 years , 21 ( 19.1 % ) of the patients r and omized to the SU and 9 ( 8.2 % ) of the patients r and omized to the GW were at home ( P=0.0184 ) . Eighty-three ( 75.5 % ) of the patients from the SU and 96 ( 87.3 % ) of the patients from the GW were dead ( P=0.0082 ) , and 6 ( 5.4 % ) and 5 ( 4.5 % ) , respectively , were in an institution ( eg , nursing home ; NS ) . Twenty-two ( 20.0 % ) of the SU patients and 9 ( 8 . 2 % ) of the GW patients had a Barthel Index score of > /=60 ( P=0.0118 ) , and 14 ( 12.7 % ) and 6 ( 5.4 % ) , respectively , had a score of > /=95 ( P=0.0606 ) . CONCLUSIONS For the first time it has been shown that SU care improves survival and functional state and increases the proportion of patients able to live at home 10 years after their stroke . Treatment in combined acute and rehabilitation SU seems to have important long-term effects on outcome for stroke patients 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 BACKGROUND AND PURPOSE We have previously shown that treatment in our combined acute and rehabilitation Stroke Unit improves outcome during the first year after onset of stroke compared with stroke patients treated in general wards . The aim of the present trial was to examine the long-term effects of the stroke unit care . METHODS In a r and omized controlled trial , 110 patients with symptoms and signs of an acute stroke were allocated to the Stroke Unit and 110 to general wards .  No significant differences existed in baseline characteristics between the two groups . The outcome after 5 years was measured by the proportion of patients at home , the proportion of patients in an institution , the mortality , and the functional state assessed by Barthel Index . RESULTS After 5 years , 38 ( 34.5 % ) of the patients r and omized to the Stroke Unit and 20 ( 18.2 % ) of the patients r and omized to the general wards were at home ( P = .006 ) . Sixty-five ( 59.1 % ) of the patients from the Stroke Unit and 78 ( 70.9 % ) of the patients from the general wards were dead ( P = .041 ) , while 7 ( 6.4 % ) and 12 ( 10.9 % ) , respectively , were in an institution ( e.g. , nursing home ) ( P = NS ) . Functional state was significantly better for patients treated in the Stroke Unit . CONCLUSIONS For the first time it is shown that stroke unit care improves long-term survival and functional state and increases the proportion of patients able to live at home 5 years after the stroke . Combined acute and rehabilitation stroke units appear to be an effective way of organizing treatment for acute stroke patients Background and Purpose — The benefits of stroke unit management may vary according to stroke subtype . A post hoc analysis of the influence of stroke subtype on stroke unit effectiveness was undertaken by using prospect i ve data collected in a r and omized controlled trial . Methods — Two hundred sixty-seven patients with moderately severe ischemic stroke ( 164 with large-vessel infa rcts and 103 with lacunar infa rcts ) were r and omly allocated to treatment in stroke units or in general medical wards with specialist stroke team support .  Mortality , institutionalization , neurological , functional , and quality -of-life scores and re source use were assessed at 3 and again at 12 months after stroke onset . An intention-to-treat analysis was undertaken , and logistic regression was used to evaluate the independent effect of stroke unit intervention . Results — Stroke team – supported management was associated with higher mortality ( odds ratio [ OR ] 4.9 , 95 % CI 1.3 to 18.6 ) and higher mortality or institutionalization ( OR 2.9 , 95 % CI 1.1 to 7.4 ) at 3 months ( OR 3.6 , 95 % CI 1.5 to 8.7 ) and at 1 year ( OR 2.8 , 95 % CI 1.3 to 6.2 ) in patients with large-vessel infa rcts . In contrast , there were no significant differences in outcome in patients with lacunar strokes managed in the stroke unit or by the stroke team . In patients with lacunar strokes , stroke unit care was associated with a longer length of hospital stay ( 18 versus 13.5 days for stroke unit care versus stroke team care , respectively;P < 0.01 ) and significantly greater use of therapy . Conclusions — Stroke units improve the outcome in patients with large-vessel infa rcts but not in those with lacunar syndromes . For lacunar strokes , stroke unit management may be associated with higher initial health costs for equivalent benefit 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 — Although several studies have demonstrated the effectiveness of specialist Stroke Unit ( SU ) care of stroke patients , there is still disagreement over how these units are best organized . We sought to clarify the role of continuous monitoring of physiological parameters in acute ischemic stroke . Methods — We conducted a prospect i ve study of 268 first-ever ischemic stroke patients admitted to our Cerebrovascular Department and allocated , according to the availability of beds , to the SU or Cerebrovascular Unit ( CU ) .  Statistical analysis compared mortality and outcome at discharge , medical and neurological complications , and length of hospitalization in the 2 care setting s. Results — Two hundred sixty-eight patients were enrolled . A good outcome at discharge , observed in 114 SU patients ( 85 % ) and 78 CU patients ( 58 % ) ( odds ratio , 2.63 ; 95 % CI , 1.4 to 4.8 ; P < 0.02 ) , was found , on multivariate analysis , to be significantly related to type of care ( SU versus CU ) . A significantly greater proportion of SU patients showed adverse changes in monitored parameters , which required acute medical treatment ( SU : 64 % ; CU : 19 % ; P < 0.0001 ) . The mean duration of these complications was significantly shorter in the SU patients ( SU : 1.0 day ; CU : 2.4 days ; P < 0.02 ) , and the outcome in patients experiencing complications covered by the monitoring protocol was significantly better in the SU ( 66 % ) than in the CU ( 35 % ) group ( P < 0.0001 ) . Conclusions — Admission of acute stroke patients to a monitoring SU may positively influence their outcome at discharge . Confirmation of our findings in larger trials will indicate the need for a revision of the minimum requirements of SUs , with the addition of monitoring as a new requirement BACKGROUND AND PURPOSE Elderly stroke patients in particular are at risk of receiving less than optimal care . We studied the effects of the department care ( medicine versus neurology ) on the outcome of elderly stroke patients in a r and omized controlled trial with 1-year follow-up . METHODS A total of 243 consecutive patients aged 65 years or older with acute stroke were r and omized to receive care in the Departments of Medicine or the Department of Neurology of a university teaching hospital with a referral area of 1.1 million . The outcome was assessed by mortality , length of hospital stay , ability to live at home on discharge , Barthel Index , and Rankin grade s at 1 year . RESULTS There were no differences in sex and age , severity or type of stroke , other diseases , or social factors between the two groups . One-year mortality was 21 % in both patients treated by the Departments of Medicine and those treated by the Department of Neurology . Patients treated by the Department of Neurology were discharged 
    Output:
    
Outcomes were independent of patient age , sex or stroke severity , but appeared to be better in stroke units based in a discrete ward .
There was no indication that organised stroke unit care result ed in a longer hospital stay .
AUTHORS ' CONCLUSIONS Stroke patients who receive organised inpatient care in a stroke unit are more likely to be alive , independent , and living at home one year after the stroke .
The benefits were most apparent in units based in a discrete ward .
No systematic increase was observed in the length of inpatient stay