Stroke Unit Care Is Beneficial Both for the Patient and for the Health Service and Should Be Widely Implemented

See related article, pages 18–23. Stroke unit (SU) care is the only treatment option for acute stroke with proven reduction of death.1 It is also the only intervention that has shown a reduction in long-term dependency, and the majority of stroke patients benefit from this intervention.1 Hence, SU care is by far the most important treatment for stroke patients and the only treatment of acute stroke that has a major impact on the burden of stroke.1–3It is important to recognize that the organization of stroke services per se plays a key role in improving the overall outcome after a stroke. Despite impressive results, the implementation of SU care is remarkably slow in many countries. A hospital survey from the United States showed that SU care was established at only 38% of the hospitals.4 In a registry of the Canadian Stroke Network, only 31% of stroke patients received care in an SU.5 Similar problems in translating knowledge into practice are also present in many other regions and countries worldwide.6,7 It is mainly the Scandinavian countries that have implemented SUs on a large scale,8 especially Sweden, where >80% of all patients with acute stroke are offered SU care.The positive effects of SU care not only are found in randomized trials but also persist when SUs are implemented in routine clinical practice.9 Hence, the consequences of the lack of a wide implementation of SUs are probably that many stroke patients will die unnecessarily or will become dependent and require long-term institutional …