Stroke ward care showed a reduction in the odds of a poor outcome at the end of follow‐up (OR 0.78, 95% CI 0.68 to 0.91 moderate‐quality evidence).ĭirect comparison of mobile stroke team versus general ward: two trials (438 participants) compared care from a mobile stroke team with care in general wards. The analysis of different types of organised (stroke unit) care used both direct pairwise comparisons and NMA.ĭirect comparison of stroke ward versus general ward: 15 trials (3523 participants) compared care in a stroke ward with care in general wards. When calculated as the absolute risk difference for every 100 participants receiving stroke unit care, this equates to two extra survivors, six more living at home, and six more living independently. Outcomes appeared to be independent of patient age, sex, initial stroke severity, stroke type, and duration of follow‐up.

Sensitivity analyses indicated that observed benefits remained when the analysis was restricted to securely randomised trials that used unequivocally blinded outcome assessment with a fixed period of follow‐up. There was no indication that organised stroke unit care resulted in a longer hospital stay. Analysis of length of stay was complicated by variations in definition and measurement plus substantial statistical heterogeneity (I² = 85%). Evidence was of very low quality for subjective health status and was not available for patient satisfaction.

We included 29 trials (5902 participants) that compared organised inpatient (stroke unit) care with an alternative service: 20 trials (4127 participants) compared organised (stroke unit) care with a general ward, six trials (982 participants) compared different forms of organised (stroke unit) care, and three trials (793 participants) incorporated more than one comparison.Ĭompared with the alternative service, organised inpatient (stroke unit) care was associated with improved outcomes at the end of scheduled follow‐up (median one year): poor outcome (odds ratio (OR) 0.77, 95% confidence interval (CI) 0.69 to 0.87 moderate‐quality evidence), death (OR 0.76, 95% CI 0.66 to 0.88 moderate‐quality evidence), death or institutional care (OR 0.76, 95% CI 0.67 to 0.85 moderate‐quality evidence), and death or dependency (OR 0.75, 95% CI 0.66 to 0.85 moderate‐quality evidence).

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