Mobile Stroke Units: Evidence, Gaps, and Next Steps

Area of Science:

• Emergency Medicine
• Neurology
• Prehospital Care

Background:

• Mobile stroke units (MSUs) are advanced ambulances providing in-transit stroke diagnosis and treatment.
• MSUs have expanded globally, with recent trials confirming their clinical benefits.

Purpose of the Study:

• To evaluate the safety and efficacy of Mobile Stroke Units (MSUs) in improving patient outcomes for acute stroke.
• To assess the impact of MSUs on treatment times and functional recovery compared to conventional emergency care.

Main Methods:

• Analysis of two large, controlled clinical trials (B_PROUD and BEST-MSU).
• Comparison of outcomes for patients treated on MSUs versus those receiving standard emergency medical services.

Main Results:

• Treatment on MSUs was demonstrated to be safe and led to improved functional outcomes.
• MSUs significantly increased the rate of ultra-early thrombolysis within the critical "golden hour" of stroke onset.
• The benefits of MSUs were comparable to established interventions like intravenous thrombolysis and stroke units.

Conclusions:

• Mobile stroke units (MSUs) represent a proven, effective intervention for acute stroke care, significantly improving patient outcomes.
• Further integration, reimbursement, and research are needed to optimize MSU implementation and accessibility worldwide.
• Key areas for future development include cost-effectiveness, nonurban utility, and advanced neuroimaging integration.