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Ambulance-Based Mobile Units Avert Strokes, Finds Study

By HospiMedica International staff writers
Posted on 30 Oct 2023
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Image: Mobile stroke units bring the emergency room to the patient (Photo courtesy of NewYork-Presbyterian)
Image: Mobile stroke units bring the emergency room to the patient (Photo courtesy of NewYork-Presbyterian)

Strokes are a major global health concern, being the primary cause of disability and death around the world. For each untreated minute following a stroke, a patient loses about 2 million neurons. In essence, one hour without treatment is equivalent to losing the same number of neurons as one would through over three years of natural aging. Rapid intervention is crucial for reducing brain damage and improving chances of recovery. Now, a new study has shown that administering clot-dissolving medication via a Mobile Stroke Unit (MSU) enhances stroke prevention and full recovery, as compared to standard hospital emergency services.

The collaborative study that included researchers from Weill Cornell Medicine (New York, NY, USA) found that patients treated with an MSU had an 18% chance of averting a stroke, compared to an 11% chance with traditional Emergency Medical Services (EMS). Additionally, 31% of MSU-treated patients showed early symptom resolution within a day following the stroke, compared to 21% with standard EMS. The medication used was tissue plasminogen activator (t-PA), which is injected intravenously to dissolve blood clots blocking arteries to the brain, making quick treatment essential.

Data from multiple centers collected between 2014 and 2020 was analyzed, involving 1,009 patients. Of these, 644 were administered t-PA through an MSU, while 365 received standard EMS care. On average, t-PA was given 87 minutes after stroke symptoms appeared. The study revealed that about one in four patients with suspected strokes showed recovery within the first 24 hours when t-PA was administered within this period, and one in six experienced no lasting brain injury, as confirmed by MRI scans.

Patients receiving MSU-based care had better outcomes mainly because the treatment started 37 minutes sooner compared to those treated by EMS. This speedier administration of t-PA within the vital first hour greatly enhanced the likelihood of averting a stroke and helped nearly a third of the patients to return to normal within a day. The study also highlighted other variables contributing to favorable outcomes, such as treatment within the initial 45 minutes, being younger in age, female, a history of high cholesterol, lower blood pressure, lower severity of the stroke, and absence of large blood vessel blockages.

“Such studies will hopefully lead to a shift in regulations and reimbursements, and how MSUs are led, managed and integrated within emergency medical services,” said Dr. Babak Benjamin Navi at Weill Cornell who is now working on a study to evaluate the cost-effectiveness of MSUs.

Related Links:
Weill Cornell Medicine 

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