The Effect of Stroke Units on The Management of Ischemic Stroke Patients in the Emergency Department: A Retrospective 5-Year Study

Aim: Ischemic stroke is one of the leading causes of morbidity and mortality Worldwide. It is recommended to treat stroke patients in specialized care centers known as stroke units (SU). The aim of this study is to investigate the impact of the stroke unit on the treatment of stroke patients in the emergency department (ED). Material and Methods: This retrospective observational study was performed in the emergency department of Dokuz Eylül University Faculty of Medicine Hospital. Patients aged 18 years and over with a diagnosis of ischemic stroke were included in the study. A comparison was made between the demographic characteristics, treatments given, length of stay in the emergency department and hospital, and mortality rates before and after the SU was introduced. Results: A total of 1,546 patients were included in this study; 583 of the patients were admitted before the SU was established, and 963 were admitted after. The majority of stroke patients (56%) were male. The mean age of patients before the SU was 72±12.4 years and after SU it was 70±12.9 years. The highest number of admissions was observed in the 71-80 age group. The most common symptoms for hospital admission were weakness in arms and legs and dysarthria. Thrombolytic treatment was administered to 1.2% of ischemic stroke patients before the SU and 5.5% after the SU (p=0.00). The mean hospital length of stay was 10.7±8.3 days before the SU and 9.4±8.3 days after. Mortality was 8.6% before the SU and 6.7% after. Conclusion: The establishment of the Stroke Unit (SU) resulted in an increased rate of thrombolytic treatment. In thisstudy SU had no effect on mortality. Despite the increase in the number of patients, there was no change in the length of stay in the ED; however, hospital length of stay was shortened.