MSUs improve odds of averting and recovering fully from stroke: study

por John R. Fischer, Senior Reporter | November 03, 2023
Emergency Medicine Stroke
Mobile stroke units deliver treatment 37 minutes faster than emergency medical services. (Photo courtesy of NewYork-Presbyterian)
Being on board an ambulance-based mobile stroke unit may increase a patient’s chances of averting or recovering fully from a stroke.

Researchers at nine medical centers across the U.S. found in a recent study that compared to standard emergency medical services, MSUs delivered treatment 37 minutes faster, allowing patients to receive vital care within the first crucial hour, and increased the odds of averting a stroke with nearly one-third of patients recovering within 24 hours.

According to their findings, MSUs increased stroke aversion by 18%, compared to 11% with EMS care, and 31% of patients fully recovered within 24 hours, compared to 21%.
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“The brain can only sustain reduced blood flow for so long before permanent injury develops,” said lead author Dr. Babak Benjamin Navi, associate professor, vice chair for hospital neurology services, and chief of stroke and hospital neurology, at Weill Cornell Medicine.

MSUs include CT scanners and are staffed with paramedics, a CT technologist, a critical care nurse, and a neurologist who is available either in person or via telemedicine. Patients on board received a tissue plasminogen activator (t-PA), an intravenous medication for dissolving clots, and a mainstay treatment.

The researchers evaluated multicenter trial data from 2014 to 2020 on 1,009 patients — 644 who received a t-PA in an MSU, and 365 who received EMS care. Patients received t-PA at a median interval of 87 minutes, which allowed for about one in four with a suspected stroke to recover within 24 hours and one in six to avert a stroke and show no signs of brain injury on an MR scan.

Other factors contributed to better outcomes, including treatment within the first 45 minutes, younger age, being female, history of high cholesterol, lower blood pressure, lower stroke severity, and no blockage of large blood vessels.

The findings align with a previous study that found that MSUs resulted in better outcomes and less chance of disability among ischemic stroke patients in 90 days, compared to emergency medical service ambulances.

Another in Germany also found that they speed up treatment and may reduce the odds of incurring disabilities when equipped with CT scanners and labs specifically designed for stroke treatment.

In addition to Weill Cornell Medicine, institutional authors included NewYork-Presbyterian, UTHealth Houston, Memorial Hermann-Texas Medical Center, Mills-Peninsula Medical Center, the University of Colorado, Baylor College of Medicine, Columbia University Irving Medical Center, and Ronald Reagan UCLA Medical Center.

The findings were published in the Annals of Neurology.

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