Abstract WP44: Long Functional Outcomes After Acute Stroke Treatment After Implementation Of Mobile Stroke Unit Program

Abstract

Background: Mobile stroke units (MSU) were developed as a tool to facilitate rapid delivery of acute stroke treatments and improving patient functional outcomes. Currently, there is limited data on the functional outcomes of patients receiving acute stroke treatments after being transported by MSU. In 2019, Stony Brook University Hospital (SBUH) implemented 2 mobile stroke units to assist with rapid delivery of acute stroke treatments. We sought to compare the long-term functional outcomes of patients who received acute stroke treatment after transport by our MSU versus conventional transportation prior to MSU implementation. Methods: This is a retrospective study of patients who received either tissue plasminogen activator (t-PA) and/or thrombectomy between the years 2017-2020 (n=316). Patients were separated into two groups; Either receiving care via MSU to SBUH (n=107) or receiving care after arrival/transfer to SBUH via conventional transportation (n=165). Time interval from door to t-PA administration and door to groin puncture were measured. T test for independent samples were used to measure differences in time among both groups. Long term functional outcomes were measured using modified Rankin Scale (mRS) at 90 days. Patients were trichotomized into three outcome groups, mRS 0-1, 2-4, and 5-6. Chi square was used to analyze differences among the outcome groups. Results: The MSU patients had a significantly shorter Door to TPA time than the control group: (28 min±22 min vs. 63 min ±40 min respectively, t=4.770, 74 df, P<0.001). MSU patients had significantly shorter Door to groin puncture time than the control group (69 min ± 57 min vs 155min ± 271 min. respectively, t=2.807, 234 df, P<0.001). In MSU group (44), 41% had favorable mRS 0-1 compared to control group 23% (31) with mRS of 0-1. MSU group had 36% (44) moderate mRS 2-4 compared to control group 45% (31) with mRS of 2-4. MSU group had 23% (41) severe mRS 5-6 compared to control group 33% (31). X 2 =9.770, 2df, p <.01 Conclusions: MSU transported patients had shorter door to t-PA and thrombectomy times compared to patients using traditional EMS transfer system in Suffolk County. This improvement translated into more favorable long-term patient outcomes as seen with more MSU patients with lower 90 day mRS.