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Mobile Stroke Unit Operational Metrics: Institutional Experience, Systematic Review and Meta-Analysis
Nathaniel R Ellens1, Derrek Schartz2, Redi Rahmani1
1Department of Neurosurgery, University of Rochester Medical Center, Rochester, NY, United States.
Frontiers in Neurology
|May 26, 2022
Summary
Mobile stroke units (MSUs) show promising operational performance, with established metrics for treatment rates and utilization. These findings aid in comparing and developing mobile stroke programs.
Area of Science:
- Emergency Medicine
- Neurology
- Health Services Research
Background:
- Existing literature on mobile stroke units (MSUs) primarily examines clinical outcomes, neglecting operational performance metrics.
- There is a need for standardized metrics to evaluate and compare the efficiency of MSUs.
Purpose of the Study:
- To establish normalized operational metrics for mobile stroke units (MSUs).
- To conduct a meta-analysis of the current literature on MSU performance, focusing on key operational indicators.
Main Methods:
- A retrospective analysis of prospectively collected data from an MSU in upstate New York (October 2018 - March 2021).
- Meta-analysis of published literature using MEDLINE, SCOPUS, and Cochrane Library databases.
- Calculation of rates for tPA/dispatch, tPA/day, mechanical thrombectomy (MT)/dispatch, and MT/day.
Main Results:
- The MSU in New York had 8.5 dispatches/24-operational-hours and a 13.3% utilization rate.
- Meta-analysis revealed pooled rates of 7.2% for tPA/dispatch and 0.358 tPA/day, and 2.0% for MT/dispatch and 0.092 MT/day.
- Significant heterogeneity (I² > 67%) was observed across meta-analysis results, indicating variability in study methodologies or populations.
Conclusions:
- This study establishes key operational metrics for MSUs, including tPA/dispatch, tPA/day, MT/dispatch, MT/day, and utilization rate.
- These normalized metrics are valuable for internal benchmarking and external comparisons for institutions developing or operating mobile stroke programs.
