Effect of regional stroke units on the management of stroke patient in emergency department: Retrospective 5 years study

INTRODUCTION: Stroke is the second leading cause of deaths among adults. It has been encouraged to establish regional stroke unites (SU). We aimed to investigate the cos and pros of our hospital?s SU to the management of ischemic stroke patients in emergency department (ED).METHOD: In this retrospective study, the file charts of ischemic stroke patients who had been admitted to emergency department during a 5-year period between 1st of January, 2005 and 31st of December 2009 were reviewed according to ED management, treatment modalities and outcomes.RESULTS: During a 5-year period a total of 1546 ischemic stroke patients were identified (before SU 583 (38%) and after SU 963 (62%). There was not a statistically significance between two groups according to mean length of stay in the ED (before SU 15,6 hrs vs. after SU 15,7 hrs, p=0,93). Among men, motor ve sensorial symptoms and among cognitial symptoms were more prominent findings (X2=194.08, p=0,00; X2=6.68, p=0.01). Weakness in extremities, slurred speech, altered mental status, seizure and syncope were significantly related with early ED admission at first the 3-hour period (p=0.00). There was a significant difference between before SU and after SU according to thrombolytic therapy (p=0.00). According to outcomes, there was not significant difference between before SU and after SU for rates of deaths (X2=1,71, p=0,190; OR: 1,29 RR: 1,27).CONCLUSION: The most important benefit of SU in our hospital is the significant increase in thrombolytic therapy for acute ischemic stroke patients. However mean length of stay in the ED and the rate of in-hospital deaths were not increased despite two fold increase in patient population of ED after SU. This study failed to demonstrate that establishing the SU has a clear benefit in means of emergency medical services.Keywords: stroke unit, stroke, emergency service, ischemic stroke, thrombolytic treatment.