Effect of Mobile Stroke Unit Dispatch on Process Parameters and Functional Outcomes in Patients With Acute Stroke:...

Area of Science:

• Neurology
• Emergency Medicine
• Public Health

Background:

• Prehospital stroke care is crucial for patient outcomes.
• Mobile Stroke Units (MSUs) aim to expedite treatment like IV thrombolysis (IVT).
• Optimizing MSU workflows may enhance treatment benefits.

Purpose of the Study:

• To evaluate the impact of additional MSU dispatch on functional outcomes in acute stroke patients.
• To assess outcomes under optimized MSU organization and service delivery.
• To determine if simultaneous MSU dispatch improves patient recovery.

Main Methods:

• Nonrandomized, controlled B_PROUD-2.0 study comparing MSU dispatch vs. conventional care.
• Inclusion of patients with cerebral ischemia and disabling symptoms.
• Pooled analysis with prior B_PROUD-1.0 data and an extended cohort including all stroke/TIA patients.

Main Results:

• B_PROUD-2.0: No significant difference in primary outcomes (mRS, disability scale).
• Higher odds of IVT within 1 hour in the MSU group (OR 10.15).
• Pooled analyses (B_PROUD-1.0+2.0) showed beneficial effects on primary and co-primary outcomes (cOR 0.80, 0.79).

Conclusions:

• B_PROUD-2.0 was underpowered to show statistically significant outcome differences.
• Pooled data across B_PROUD studies indicate a beneficial effect of MSUs.
• MSUs show promise for improving outcomes in acute stroke and TIA patients.