***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 — Approximately 23 % of Australian hospitals provide Stroke Units ( SUs ) . Evidence suggests that clinical outcomes are better in SUs than with conventional care . Reasons may include greater adherence to processes of care ( PoC ) . The primary hypothesis was that adherence to selected PoC is greater in SUs than in other acute care models . Methods — Prospect i ve , multicenter , single-blinded design . Models of care investigated : SUs , mobile services , and conventional care . Selected PoC were related to care models and participant outcomes . Data were collected at acute hospitalization ( median 9 days ) and at medians of 8 and 28 weeks after stroke . Results — 1701 patients were screened from 8 hospitals , 823 were eligible , and 468 participated . Response rate was 96 % at final follow-up . Mean age was 73 years ( SD 14 ) .  Overall PoC adherence rates for individual care models were SU 75 % , mobile service 65 % , and conventional care 52 % ( P < 0.001 ) . The adjusted odds of participants being alive at discharge if adhering to all or all but 1 PoC was significant ( aOR 3.63 ; 95 % CI : 1.04 to 12.66 ; P = 0.043 ) . Important trends at 28 weeks were found for being at home ( aOR 3.09 ; 95 % CI : 0.96 to 9.87 ; P = 0.058 ) and independent ( aOR 2.61 ; 95 % CI : 0.96 to 7.10 ; P = 0.061 ) , with complete PoC adherence . Conclusion — Adherence to key PoC was higher in SUs than in other models . For all patients , adherence to PoC was associated with improved mortality at discharge and trends found with independence at home , providing support for the need to increase access to stroke units 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 Although previous studies have proved that both stroke wards and mobile stroke teams are considerably better than non-specialized stroke care , an unresolved debate in vascular neurology is whether or not stroke wards provide better outcomes in some specific cases to stroke victims . Our prospect i ve , multicenter , cohort study compared dedicated stroke wards versus specialist stroke team care at general hospital wards in 11 centers nationwide for 8743 consecutive stroke events during 18 months . Twenty-eight-day case-fatality rate was 12.6 % at stroke wards versus 15.2 % at stroke teams for all patients ( P = 0.002 ) , and stroke ward care also predicted better outcome when analyzed with multivariate logistic regression model ( odds ratio 1.701 ; confidence interval : 1.025 - 2.822 ) . Case-fatality rates were not significantly different in patients with modified Rankin score > or = 2 ( case-fatality rate : 17.8 % vs. 20.3 % ; P = 0.163 ) , and over 60 ( case-fatality rate : 14.8 % vs. 15.9 % ; P = 0.250 ) , however these patients were more probably at home after 4 weeks when treated at stroke wards ( 56.1 % vs. 50.6 % ; P = 0.03 , and 69.5 % vs. 64.5 % ; P = 0.004 ) . In our study , stroke ward admission provided lower case-fatality rate below 60 and for those independent prior to their strokes , and lower institutionalization over 60 and amongst previously dependent patients , when compared with stroke teams 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 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 an average of 16 days earlier ( 24 versus 40 days ) . The length of hospital stay of patients aged younger than 75 years differed significantly ( P = .02 ) . Patients r and omized to neurological wards more often went directly home ( 75 % versus 62 % ; P = .03 ) , and their functional status was better as assessed with Barthel Index and Rankin grade s at 1 year ( P = .02 and P = .03 , respectively ) . Independent predictors of a better functional outcome and shorter hospital stay by stepwise multivariate analysis included management by the Department of Neurology . CONCLUSIONS Well-organized management of elderly stroke patients was associated with a better outcome . It was also the more economical alternative BACKGROUND AND PURPOSE We have previously shown that treatment of acute stroke patients in our stroke unit ( SU ) compared with treatment in general ward ( GWs )  improves short- and long-term survival and functional outcome and increases the possibility of earlier discharge to home . The aim of the present study was to identify the differences in treatment between the SU and the GW and to assess which aspects of the SU care which were most responsible for the better outcome . METHODS Of the 220 patients included in our trial , only 206 were actually treated ( SU , 102 patients ; GW , 104 patients ) . For these patients , we identified the differences in the treatment and the consequences of the treatment . We analyzed the factors that we were able to measure and their association with the outcome , discharge to home within 6 weeks . RESULTS Characteristic features in our SU were teamwork , staff education , functional training , and integrated physiotherapy and nursing . Other treatment factors significantly different in the SU from the GW were shorter time to start of the systematic mobilization/training and increased use of oxygen , heparin , intravenous saline solutions , and antipyretics . Consequences of the treatment seem to be less variation in diastolic and systolic blood pressure ( BP ) , avoiding the lowest diastolic BP , and lowering the levels of glucose and temperature in the SU group compared with the GW group . Univariate analyses showed that all these factors except the level of glucose were significantly associated with discharge to home within 6 weeks . In the final multivariate Cox regression model , shorter time to start of the mobilization/training and stabilized diastolic BP were independent factors significantly associated with discharge to home within 6 weeks . CONCLUSIONS Shorter time to start of mobilization/training was the most important factor associated with discharge to home , followed by stabilized diastolic BP , indicating that these factors probably were important in the SU treatment . The effects of characteristic features of an SU , such as a specially trained staff , teamwork , and involvement of relatives , were not possible to measure . Such factors might be more important than those actually measured Background and Purpose — Pathophysiological considerations and observational studies indicate that elevated body temperature , hypoxia , hypotension , and cardiac arrhythmias in the acute phase of ischemic stroke may aggravate brain damage and worsen outcome . Methods — Both units were organized with the same st and ard care and multidisciplinary approach to nursing and rehabilitation . A blinded observer assessed functional outcome at 3 months with the modified Rankin scale ( mRS ) and Barthel Index ( BI ) . End points were ( 1 ) poor outcome , defined as either mRS ≥4 or BI < 60 or the need for institutional care and ( 2 ) mortality . Results — Fifty-four patients meeting the inclusion criteria were r and omized . The groups were well matched for baseline characteristics , stroke subtype , stroke severity , vascular risk factors , and prognostic factors . Poor outcome was seen in 7 ( 25.9 % ) patients in the SCMU group and in 13 ( 48.1 % ) in the SU group ( P = 0.16 ) . Mortality was lower in the SCMU group than in the SU group ( 1 [ 3.7 % ] vs 7 [ 25.9 % ] ; odds ratio , 0.11 [ 95 % CI , 0.02 to 0.96 ] , P = 0.05 ) . Conclusions — This pilot study suggests that admission of acute stroke patients to an SCMU may reduce mortality and poor outcome . A larger trial is required to confirm these findings Background and Purpose — The long-term beneficial effects of stroke unit care have been proved in several r and omized trials . However , there is a question of large-scale applicability in routine clinical practice of interventions used by dedicated investigators in small r and omized trials . The objective of this study was to compare , 21/2 years after stroke , patients who had been treated in stroke 
    Output:
    
We also attempt to provide some answers to several open questions regarding practical issues of stroke units