Abstract
Mobile Stroke Unit (MSU) expedites the delivery of intravenous thrombolysis in acute stroke patients. We further evaluated the functional outcome of patients shipped to a tertiary care centre or repatriated to local hospitals after triage by MSU in acute stroke syndrome in rural northern Alberta. Consecutive patients with suspected acute stroke syndrome were included. On the basis of neurology consultation and, Computed Tomography findings, patients, who were thrombolysed or needed advanced care were transported to the Comprehensive stroke center (CSC) (Triage to CSC group). Other patients were repatriated to local hospital care (Triage to LHC group). A total of 156 patients were assessed in MSU, 73 (46.8%) were female and the mean age was 66.6 ± 15 years. One hundred and eight (69.2%) patients, including 41 (26.3%) treated with thrombolysis were transported to the CSC (Triage to CSC group) and 48 (30.8%) were repatriated to local hospital care. The diagnosis made in MSU and final diagnosis were matching in 88% (95) and 91.7% (44, p = 0.39) in Triage to CSC and Triage to LHC groups respectively. Prehospital triage by MSU of acute stroke syndrome can reliably repatriate patients to the home hospital. The proposed model has the potential to triage patients according to their medical needs by enabling treatment in home hospitals whenever reasonable.
Highlights
The benefits of reperfusion therapies in acute ischemic stroke decrease over time with the best outcomes seen with early initiation of treatment1,2
While the initial focus of mobile stroke unit (MSU) has been on the earlier delivery of IV tPA, it is increasingly being recognized that MSUs can play a central role in triaging suspected stroke patients for EVT
Patients with an MSU diagnosis of acute ischemic stroke that were not thrombolysed included 39 (n = 109, 35.8%) patients with minor stroke or transient ischemic attacks (TIAs) and 29 (26.6%) patients that were outside thrombolysis window
Summary
The benefits of reperfusion therapies in acute ischemic stroke decrease over time with the best outcomes seen with early initiation of treatment. Studies have shown that MSUs decrease stroke onset to treatment times with IV tPA, and increase the percentage of patients receive reperfusion treatment and the number of patients being discharged h ome. Many suspected strokes patient will need to be screened to identify the small group who are likely to benefit from EVT (more than 7798 acute stroke syndrome patients screened 13% receive IV Thrombolysis and < 1% undergo mechanical thrombectomy in EXTEND IA study).
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
