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

Yıl 2025, Cilt: 8 Sayı: 1, 13 - 18, 29.03.2025

Cem Şimşek , Sedat Yanturalı , Dijan Tav Şimşek , Rıdvan Atilla

https://doi.org/10.54996/anatolianjem.1564648

Öz

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.

Anahtar Kelimeler

Emergency department, stroke, stroke unit, ischemic stroke, thrombolytic treatment

Etik Beyan

All authors declared that they comply with the Research and Publication Ethics rules. (Ethics committee mediation, approval date, and number: Dokuz Eylul University Hospital, Izmir, 13.01.2011; 2011/01-08) Identity information was not requested from the participants in accordance with the purpose of the study and on the basis of the confidentiality principle.

Destekleyen Kurum

This research received no specific grant from any funding agency in the public, commercial, or notfor-profit sectors.

Acil Serviste İskemik İnme Hastalarının Yönetimine İnme Ünitesinin Etkisi: 5 Yıllık Geriye Dönük Tarama

Öz

Amaç: İskemik inme dünya genelinde önemli bir morbidite ve mortalite nedenidir. Tedavi sürecinin inme ünitesi olarak adlandırılan özelleşmiş bakım merkezlerinde yapılması önerilmektedir. Bu çalışmanın amacı, inme ünitesinin (İÜ) acil servisteki inme hastalarının tedavisine etkisini araştırmaktır.

Gereç ve Yöntemler: Bu retrospektif gözlemsel çalışma Dokuz Eylül Üniversitesi Tıp Fakültesi Hastanesi Acil Servisinde yapıldı. İskemik inme tanısı alan 18 yaş üstü hastalar çalışmaya dahil edildi. İnme ünitesi öncesi ve sonrası dönemde hastaların demografik özellikleri, verilen tedaviler, acil serviste ve hastanede kalış zamanı karşılaştırıldı.

Bulgular: Bu çalışmaya 1546 hasta dahil edildi. Hastaların 583’ü İÜ öncesi, 963 tanesi İÜ sonrası dönemde hastaneye kabul edildi. İnme geçiren hastaların çoğunluğu (%56) erkekti. İÜ açılmadan önceki hastaların yaş ortalaması 72±12,4 yaş; İÜ açıldıktan sonraki yaş ortalaması 70±12,9 yaş bulundu. En çok başvurunun 71-80 yaş grubunda olduğu görüldü. Hastaların hastaneye başvuru nedenleri arasında en sık kol ve bacakta güç kaybı ve konuşma bozukluğu yer almaktadır. İÜ öncesi iskemik inme hastalarının %1,2’sine, İÜ sonrası ise %5,5’ine trombolitik tedavi verilmişti. (p=0,00). İÜ öncesi ve sonrası dönemde hastanede kalış süreleri sırasıyla 10,7 ±8,3 gün ve 9,4±8,3 gün bulunmuştur. Mortalite İÜ öncesi dönemde %8,6 iken İÜ sonrası dönemde %6,7 bulundu.

Sonuç: İÜ açılmasıyla trombolitik tedavi verilme oranında artış olmuştur. İÜ'nin mortaliteye üzerine etkisi olmamıştır. Hasta sayısının artmasına rağmen hastaların acil serviste kalış süresinde değişiklik olmamış fakat hastanede kalış süresi kısalmıştır.

Anahtar Kelimeler

Acil servis, inme, inme ünitesi, iskemik inme, trombolitik tedavi

Etik Beyan

Ethical approval was obtained from the Dokuz Eylul University Hospital Clinical Research Ethics Committee before the study (Decision No. 2011/01-08).

Destekleyen Kurum

Destekleyen kurum yoktur.

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