Outcomes of Ischemic Stroke Care in Mobile Stroke Units Superior to Ambulances
Data from the BEST-MSU study (NCT02190500) presented at the International Stroke Conference, held online March 17-19, 2021, showed care for individuals with ischemic stroke in mobile stroke units (MSUs) was superior compared with standard ambulance care (Table).
“Our goal in this study was to treat patients on the mobile stroke unit within an hour of the onset of their stroke symptoms, and we were gratified that one-third of the patients were actually treated within that time frame,” said James C. Grotta, M.D., lead study author and director of stroke research at the Clinical Institute for Research and Innovation at Memorial Herman--Texas Medical Center in Houston. “Our study confirmed that patients who are treated early benefit from a complete reversal of stroke symptoms and avoidance of disability. This suggests that in the first hour after a stroke occurs, the brain is not yet irreversibly damaged and is very amenable to effective treatment.”
“Our results mean that, on average, for every 100 patients treated on a mobile stroke unit rather than standard ambulance, 27 will have less final disability and 11 of the 27 will be disability-free,” Grotta said. “But for this to happen, patients, caregivers and bystanders need to recognize the signs of stroke and call 9-1-1 immediately.”
“More widespread deployment of mobile stroke units may have a major public health impact on reducing disability from stroke,” said Grotta. “Although mobile stroke units are costly to equip and staff, they reduce the time to treatment. We also expect that more treatment via mobile stroke units can reduce the need for downstream utilization of long-term care.”
The BEST-MSU trial is ongoing and will assess health care utilization of those enrolled over a 1-year period after their stroke and aims to evaluate cost-effectiveness of MSUs. The American Heart Association’s 2019 Recommendations for the Establishment of Stroke Systems of Care suggests reimbursement is an issue that warrants further investigation before widespread use of MSUs is likely.