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Five Years of Acute Stroke Unit Care: Comparing ASU and Non-ASU Admissions and Allied Health Involvement

DOI: 10.1155/2014/798258

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Background. Evidence indicates that Stroke Units decrease mortality and morbidity. An Acute Stroke Unit (ASU) provides specialised, hyperacute care and thrombolysis. John Hunter Hospital, Australia, admits 500 stroke patients each year and has a 4-bed ASU. Aims. This study investigated hospital admissions over a 5-year period of all strokes patients and of all patients admitted to the 4-bed ASU and the involvement of allied health professionals. Methods. The study retrospectively audited 5-year data from all stroke patients admitted to John Hunter Hospital and from nonstroke patients admitted to the ASU . The study’s primary outcomes were admission rates, length of stay (days), and allied health involvement. Results. Over 5 years, 47% of stroke patients were admitted to the ASU. More male stroke patients were admitted to the ASU (ch ; ). There was a trend over time towards parity between the number of stroke and nonstroke patients admitted to the ASU. When compared to those admitted elsewhere, ASU stroke patients had a longer length of stay ( ; ) and were more likely to receive allied healthcare. Conclusion. This is the first study to report 5 years of ASU admissions. Acute Stroke Units may benefit from a review of the healthcare provided to all stroke patients. The trends over time with respect to the utilisation of the John Hunter Hospitall’s ASU have resulted in a review of the hospitall’s Stroke Unit and allied healthcare. 1. Introduction In Australia, stroke is the leading cause of long-term disability and the second most common cause of death [1]. The two most effective interventions after stroke are organised Stroke Unit Care [2] and thrombolysis [3]. The National Stroke Foundation’s clinical guidelines identified Stroke Unit Care as the most important “intervention” on offer to Australians affected by stroke [4], with evidence indicating that it increases independence, survival, and rates of living at home at 12 months by 20% [5–9]. Stroke Unit Care improves functional outcomes and decreases length of stay when compared to patients admitted elsewhere [3, 10, 11]. It is characterised by geographically designated beds and an educated and enthused multiprofessional team [6]. The Acute Stroke Unit (ASU) was introduced to provide specialised, hyperacute care and thrombolysis. Thrombolysis was first licensed in 1996 for use in stroke in the United States of America [12], and despite its efficacy in those with an ischemic stroke, evidence indicates that it is still only available to a limited number of patients. For the purposes of this paper, an ASU


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