Yonsei Med J.  2013 Mar;54(2):301-305. 10.3349/ymj.2013.54.2.301.

Beneficial Effects of Stroke-Unit Care in Stroke Patients with Atrial Fibrillation

• Choi HY
• Seo JH
• Yang JH
• Kim YD
• Jung YH
• Cho HJ
• Nam HS
• Heo JH

• KMID: 1503889
• DOI: http://doi.org/10.3349/ymj.2013.54.2.301

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.

Keyword

Acute stroke; atrial fibrillation; anticoagulation; stroke units

MeSH Terms

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
Warfarin
Anticoagulants

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