Objective To investigate the current status of ischemic stroke patients admitted to stroke units in
China, and the effect of stroke unit on the quality of medical care and outcome for acute stroke
patients.
Methods Data were collected from a national, multi-center inhospital ischemic stroke registry.
According to the status of stroke unit, the subjects were divided into stroke unit group and nonstroke
unit group. The differences in 11 key performance indexes (KPIs) of stroke medical care and
inhospital outcomes (stroke recurrence, composite vascular events, all-cause death) were compared
between the two groups. Multivariate regression analysis was used to analyze the correlation
between stroke unit and KPIs, and between stroke unit and inhospital outcomes.
Results A total of 269 428 inpatients with acute ischemic stroke from national 1374 hospitals
were included in this study. Among them, 63 548 patients (23.6%) were included into the stroke
unit group. Stroke unit was independently associated with higher proportion of rt-PA intravenous thrombolysis (OR 1.48, 95%CI 1.43-1.53), early antithrombotics (OR 1.13, 95%CI 1.10-1.17), deep
venous thrombosis (DVT) prophylaxis (OR 1.19, 95%CI 1.16-1.22), swallowing screening (OR
1.36, 95%CI 1.32-1.39), rehabilitation evaluation (OR 1.31, 95%CI 1.28-1.34), antithrombotics at
discharge (OR 1.12, 95%CI 1.08-1.15), anticoagulation for atrial fibrillation (OR 1.13, 95%CI 1.08-
1.19), smoking cessation (OR 1.22, 95%CI 1.20-1.25). In addition, stroke unit was independently
associated with a lower rate of stroke recurrence (HR 0.79, 95%CI 0.75-0.82) and composite
vascular events (HR 0.80, 95%CI 0.77-0.84) (all P <0.001).
Conclusions Patients admitted to stroke unit had better KPIs of stroke medical quality, and had
lower recurrence rate and composite vascular event rate during the hospital stay.
