• World Neurosurg · Oct 2022

    Improved Functional Outcomes of Stroke Patients undergoing Mechanical Thrombectomy after Arriving via Mobile Stroke Unit.

    • Fadi Al Saiegh, Lohit Velagapudi, Omaditya Khanna, Michael P Baldassari, Nikolaos Mouchtouris, Karim Hafazalla, John Roussis, Maureen DePrince, Stavropoula Tjoumakaris, M Reid Gooch, Nabeel Herial, Robert H Rosenwasser, and Pascal Jabbour.
    • Department of Neurosurgery, University of Texas Health Science Center, San Antonio, Texas, USA. Electronic address: alsaiegh@uthscsa.edu.
    • World Neurosurg. 2022 Oct 1; 166: e546e550e546-e550.

    BackgroundMobile stroke units (MSUs) have been implemented worldwide for stroke care, but outcome data are lacking to show their efficacy specifically in patients undergoing mechanical thrombectomy (MT). Here, we include patients from our stroke network MSU and compare them to patients who arrived conventionally.MethodsA retrospective review of a stroke database was performed to identify patients who underwent MT after arrival via an MSU from August 2019 to December 2020. Demographic factors, past medical history, stroke characteristics, treatment variables, complications, and functional outcomes were recorded. These were compared to date-matched patients who underwent MT after arrival via conventional means.ResultsSeven patients were treated with MT after arriving by an MSU. These patients were compared to 50 date-matched patients who underwent thrombectomy after arrival through conventional means. No statistically significant difference between cohorts was observed in terms of demographic variables, comorbidities, stroke characteristics, or tissue plasminogen activator administration. Patients from the MSU cohort had significantly shorter time from symptom onset to groin puncture time (191.33 minutes ±77.53 vs. 483.51 minutes ±322.66, P = 0.034). Importantly, MSU-transferred patients had significantly better discharge functional status measured by using the modified Rankin Scale (1.86 ± 1.35 vs. 3.57 ± 1.88, P = 0.024). No significant difference in final thrombolysis in cerebral infarction score, complications, length of stay, or mortality was observed.ConclusionsOur pilot study demonstrates the efficacy of the MSU in decreasing door-to-puncture time and a concordant improvement in the discharge modified Rankin Scale score. Further prospective studies are needed to assess cost-efficacy and optimal protocol for MSUs in stroke care.Copyright © 2022 Elsevier Inc. All rights reserved.

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