Beneficial effects of stroke-unit care in stroke patients with atrial fibrillation

• Published in: Yonsei medical journal Vol. 54; no. 2; pp. 301 - 305
• Main Authors: Choi, Hye-Yeon, Seo, Joo Hyun, Yang, Jae Hoon, Kim, Young Dae, Jung, Yo Han, Cho, Han Jin, Nam, Hyo Suk, Heo, Ji Hoe
• Format: Journal Article
• Language: English
• Published: Korea (South) Yonsei University College of Medicine 01.03.2013; 연세대학교의과대학
• Subjects: 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; Original; Recurrence; Stroke - diagnosis; Treatment Outcome; Warfarin - therapeutic use; 의학일반
• ISSN: 0513-5796; 1976-2437
• DOI: 10.3349/ymj.2013.54.2.301

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. 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). 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. 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.