Beneficial Effects of Stroke-Unit Care in Stroke Patients with Atrial Fibrillation.
10.3349/ymj.2013.54.2.301
- Author:
Hye Yeon CHOI
1
;
Joo Hyun SEO
;
Jae Hoon YANG
;
Young Dae KIM
;
Yo Han JUNG
;
Han Jin CHO
;
Hyo Suk NAM
;
Ji Hoe HEO
Author Information
1. Department of Neurology, Yonsei University College of Medicine, Seoul, Korea. jhheo@yuhs.ac
- Publication Type:Original Article ; Evaluation Studies ; Research Support, Non-U.S. Gov't
- Keywords:
Acute stroke;
atrial fibrillation;
anticoagulation;
stroke units
- MeSH:
Adolescent;
Adult;
Aged;
Aged, 80 and over;
Anticoagulants/therapeutic use;
Atrial Fibrillation/*diagnosis;
Child;
Electrocardiography/*methods;
Female;
*Hospital Departments;
Humans;
Male;
Middle Aged;
Monitoring, Physiologic;
*Neurology;
Recurrence;
Stroke/*diagnosis;
Treatment Outcome;
Warfarin/therapeutic use
- From:Yonsei Medical Journal
2013;54(2):301-305
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Continuous cardiac monitoring in a stroke unit (SU) may improve detection of atrial fibrillation (AF), and SU care may improve the rate of anticoagulation by better adherence to a standardized treatment protocol in patients with AF. We investigated the effects of the SU on the detection of AF and the rate of warfarin therapy in patients with AF. MATERIALS AND METHODS: Acute stroke patients who had been admitted before or after the opening of the SU were included in our study. SU patients were monitored continuously with electrocardiography. Rates of AF and warfarin therapy were compared between patients admitted to the SU (SU group) and those admitted to the general ward (GW) prior to the opening of the SU (GW group). RESULTS: Total 951 patients had been admitted to the GW prior to the opening of the SU (from January 2000 to November 2002), and 2349 patients to the SU (from January 2003 to December 2008). AF was found in 149 patients (15.7%) in the GW group and in 487 (20.7%) in the SU group. Most of AF detected during admission was paroxysmal AF (84.8%). The frequency of newly detected AF was higher in the SU group than the GW group (2.5% vs. 0.7%, p=0.001). The rate of anticoagulation consideration was also higher in the SU group. CONCLUSION: SU care improved the detection of AF and the rate of anticoagulation consideration in acute stroke patients. Our findings support the benefits of continuous cardiac monitoring in the SU for stroke patients.
