Stroke Unit Care Benefits Patients With Intracerebral Hemorrhage

But you didn't follow the results all the way thru to % recovery.  That would prove that even with less death and disability they still don't know how to get survivors to 100% recovery. We have stroke medical staff so focused on their specialty that they can't see the failure in the big picture. Only 10% get to full recovery. Once again we see no new research, just lazy meta-analysis.
FIX that!!!
http://stroke.ahajournals.org/content/44/11/3044.abstract

1. Peter Langhorne, PhD;
2. Patricia Fearon, MBChB;
3. Ole M. Ronning, MD;
4. Markku Kaste, MD;
5. Heikki Palomaki, MD;
6. Kostos Vemmos, MD;
7. Lalit Kalra, MD;
8. Bent Indredavik, MD;
9. Christian Blomstrand, MD;
10. Helen Rodgers, MBChB;
11. Martin S. Dennis, MD;
12. Rustam Al-Shahi Salman, MD
13. on behalf of the Stroke Unit Trialists’ Collaboration

+ Author Affiliations

1. From the Academic Section of Geriatric Medicine, Royal Infirmary, Glasgow, United Kingdom (P.L., P.F.); Department of Neurology, Akershus University Hospital, Norway (O.M.R.); Department of Neurology, Helsinki University Central Hospital, Finland (M.K., H.P.); Acute Stroke Unit, Department of Clinical Therapeutics, School of Medicine, University of Ioannina, Greece (K.V.); Department of Stroke Medicine, King’s College Hospital, London, United Kingdom (L.K.); Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway (B.I.); Institute of Clinical Neuroscience, Sahlgrenska University Hospital, Göteborg University, Sweden (C.B.); Institute of Ageing and Health, Medical School, Newcastle upon Tyne, United Kingdom (H.R.); and Division of Clinical Neurosciences, University of Edinburgh, Edinburgh, United Kingdom (M.S.D., R.A.-S.S.).

1. Correspondence to Peter Langhorne, PhD, Academic Section of Geriatric Medicine, Level 4, Walton Building, Royal Infirmary, Glasgow G4 0SF, United Kingdom. E-mail Peter.Langhorne@glasgow.ac.uk

Abstract

Background and Purpose—Patients with any type of stroke managed in organized inpatient (stroke unit) care are more likely to survive, return home, and regain independence. However, it is uncertain whether these benefits apply equally to patients with intracerebral hemorrhage and ischemic stroke.

Methods—We conducted a secondary analysis of a systematic review of controlled clinical trials comparing stroke unit care with general ward care, including only trials published after 1990 that could separately report outcomes for patients with intracerebral hemorrhage and ischemic stroke. We performed random-effects meta-analyses and tested for subgroup interactions by stroke type.

Results—We identified 13 trials (3570 patients) of modern stroke unit care that recruited patients with intracerebral hemorrhage and ischemic stroke, of which 8 trials provided data on 2657 patients. Stroke unit care reduced death or dependency (risk ratio [RR], 0.81; 95% confidence interval [CI], 0.471–0.92; P=0.0009; I²=60%) with no difference in benefits for patients with intracerebral hemorrhage (RR, 0.79; 95% CI, 0.61–1.00) than patients with ischemic stroke (RR, 0.82; 95% CI, 0.70–0.97; P_interaction=0.77). Stroke unit care reduced death (RR, 0.79; 95% CI, 0.64–0.97; P=0.02; I²=49%) to a greater extent for patients with intracerebral hemorrhage (RR, 0.73; 95% CI, 0.54–0.97) than patients with ischemic stroke (RR, 0.82; 95%, CI 0.61–1.09), but this difference was not statistically significant (P_interaction=0.58).

Conclusions—Patients with intracerebral hemorrhage seem to benefit at least as much as patients with ischemic stroke from organized inpatient (stroke unit) care.