Cochrane · systematic review · CD000197
Organised inpatient (stroke unit) care for stroke: network meta‐analysis
Langhorne, P, Ramachandra, S · Cochrane Database of Systematic Reviews · 2020 · Cochrane Library
StrokeAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
28
current version
GRADE rated
22
No studies
6
Included studies
NR
No studies 6 · 21.4%Ungraded 0 · 0%Very low 4 · 14.3%Low 10 · 35.7%Moderate 8 · 28.6%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Organised inpatient (stroke unit) care versus alternative service
Population: adults with acute stroke
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Poor outcome by the end of scheduled Organised inpatient (stroke unit) care vs alternative service | OR 0.77 [0.69, 0.87] | 26 studies · 5336 participants | Moderate Downgraded: risk of bias |
Death by the end of scheduled Organised inpatient (stroke unit) care vs alternative service | OR 0.76 [0.66, 0.88] | 29 studies · 5902 participants | Moderate Downgraded: risk of bias |
Death or institutional care by the end of scheduled Organised inpatient (stroke unit) care vs alternative service | OR 0.76 [0.67, 0.85] | 25 studies · 4887 participants | Moderate Downgraded: risk of bias |
Death or dependency by the end of scheduled Organised inpatient (stroke unit) care vs alternative service | OR 0.75 [0.66, 0.85] | 24 studies · 4854 participants | Moderate Downgraded: risk of bias |
Subjective health status score Participant quality of life (Nottingham Health Profile; Quality of Life Scale) Organised inpatient (stroke unit) care vs alternative service | no estimate extracted | 3 studies · 843 participants | Very low Downgraded: risk of bias |
Patient satisfaction or preference Organised inpatient (stroke unit) care vs alternative service | no estimate extracted | NR | No studies |
Length of stay (days) in a hospital or institution (Analysis 1.5) Organised inpatient (stroke unit) care vs alternative service | SMD 0.16 | 19 studies · 4162 participants | Low Downgraded: risk of bias |
Stroke ward versus general medical ward
Population: adults with acute stroke
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Poor outcome by the end of scheduled Stroke ward vs general medical ward | OR 0.78 [0.68, 0.91] | 14 studies · 3321 participants | Moderate Downgraded: risk of bias |
Death by the end of scheduled Stroke ward vs general medical ward | OR 0.75 [0.63, 0.9] | 15 studies · 3523 participants | Moderate Downgraded: risk of bias |
Death or institutional care by the end of scheduled Stroke ward vs general medical ward | OR 0.74 [0.63, 0.87] | 13 studies · 2924 participants | Moderate Downgraded: risk of bias |
Death or dependency by the end of scheduled Stroke ward vs general medical ward | OR 0.75 [0.64, 0.88] | 12 studies · 2839 participants | Moderate Downgraded: risk of bias |
Subjective health status score Participant quality of life (Nottingham Health Profile; Quality of Life Scale) Stroke ward vs general medical ward | no estimate extracted | 2 studies · 535 participants | Very low Downgraded: risk of bias |
Patient satisfaction or preference Stroke ward vs general medical ward | no estimate extracted | NR | No studies |
Length of stay (days) in a hospital or institution (Analysis 2.5) Stroke ward vs general medical ward | SMD 0.13 | 10 studies · 2547 participants | Low Downgraded: risk of bias |
Mobile stroke team versus general medical ward
Population: adults with acute stroke
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Poor outcome by the end of scheduled Mobile stroke team vs general medical ward | OR 0.8 [0.52, 1.22] | 2 studies · 438 participants | Low Downgraded: risk of bias |
Death by the end of scheduled Mobile stroke team vs general medical ward | OR 1.08 [0.71, 1.65] | 2 studies · 438 participants | Low Downgraded: risk of bias |
Death or institutional care by the end of scheduled Mobile stroke team vs general medical ward | OR 1.27 [0.84, 1.93] | 2 studies · 438 participants | Low Downgraded: risk of bias |
Death or dependency by the end of scheduled Mobile stroke team vs general medical ward | OR 0.8 [0.52, 1.22] | 2 studies · 438 participants | Low Downgraded: risk of bias |
Subjective health status score Participant quality of life (EuroQol) Mobile stroke team vs general medical ward | no estimate extracted | 1 study · 308 participants | Very low Downgraded: risk of bias |
Patient satisfaction or preference Mobile stroke team vs general medical ward | no estimate extracted | NR | No studies |
Length of stay (days) in a hospital or institution (Analysis 3.5) Mobile stroke team vs general medical ward | no estimate extracted | NR | No studies |
Mixed rehabilitation ward versus general medical ward
Population: adults with acute stroke
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Poor outcome by the end of scheduled Mixed rehabilitation ward vs general medical ward | OR 0.65 [0.47, 0.9] | 6 studies · 630 participants | Low Downgraded: risk of bias |
Death by the end of scheduled Mixed rehabilitation ward vs general medical ward | OR 0.91 [0.58, 1.42] | 6 studies · 630 participants | Low Downgraded: risk of bias |
Death or institutional care by the end of scheduled Mixed rehabilitation ward vs general medical ward | OR 0.71 [0.51, 0.99] | 5 studies · 578 participants | Low Downgraded: risk of bias |
Death or dependency by the end of scheduled Mixed rehabilitation ward vs general medical ward | OR 0.65 [0.47, 0.9] | 6 studies · 630 participants | Low Downgraded: risk of bias |
Subjective health Status score Mixed rehabilitation ward vs general medical ward | no estimate extracted | NR | No studies |
Patient satisfaction or preference Mixed rehabilitation ward vs general medical ward | no estimate extracted | NR | No studies |
Length of stay (days) in a hospital or institution (Analysis 4.5) Mixed rehabilitation ward vs general medical ward | MD 0.08 | 3 studies · 387 participants | Very low Downgraded: risk of bias |