Outcome of Patients with Acute Ischemic Stroke in the First Year after the Establishment of a Stroke Care Unit

Abstract

A stroke care unit (SCU) was established at the Nippon Medical School Main Hospital on May 6, 2005. We performed a retrospective analysis of clinical data for patients with acute ischemic stroke. From among patients who were admitted to our ward, including the SCU, from May 6, 2005, through April 30, 2006, we selected 241 consecutive patients with acute ischemic stroke who could be classified by stroke subtype. An unfavorable outcome at that associated with a discharge was defined as modified Rankin Scale score of 3 or greater. We used logistic regression to identify factors that were independently and significantly related to an unfavorable outcome at discharge. Hypertension (odds ratio [OR]=3.446; confidence interval [CI]=1.195 to 9.934), valve disease (OR=3.694 CI=1.092 to 12.502), and NIH Stroke Scale score (OR=1.322 CI=1.175 to 1.450) were independent determinants of an unfavorable outcome at discharge. Smoking (OR=0.298 CI=0.105 to 0.848) was an independent determinant of a favorable outcome at discharge. No medical treatments were independent determinants for unfavorable or favorable outcomes at discharge. Education about stroke prevention, shortening of patient transport time, and emergency magnetic resonance imaging, including diffusion-weighted imaging, are needed to decrease the frequency of unfavorable outcomes at discharge.