Large data analysis highlights benefits of mobile stroke units: JAMA Neurology

Key findings:

  • MSUs improve the likelihood of an excellent outcome after 90 days for a person who experiences a stroke – by 65 per cent
  • Patients receive intra-venous thrombolysis 30 minutes quicker
  • Patients are observed to have immediate and less disability if they are treated by an MSU.

A new systematic review and meta-analysis, published today in JAMA Neurology, provides strong evidence for the benefits of mobile stroke units (MSUs).  The article, a collaboration of international authors including members of the Australian Stroke Alliance, showed that MSUs improve the likelihood of an excellent outcome after 90 days for a person who experiences a stroke by 65 per cent when compared with the standard care model.  As well, patients received intra-venous thrombolysis 30 minutes quicker and had an observed reduction in disability if they were treated by an MSU.

 

This data reinforces the Australian Stroke Alliance’s mission to take pre-hospital brain imaging to patients via road and air ambulances.  Using cutting-edge imaging technologies, the Alliance aims to improve pre-hospital care and the long-term outcomes for Australians, regardless of postcode.  The Melbourne mobile stroke unit continues to deliver impressive results since it took to the roads in 2017.

 

More than 249 people have been thrombolysed on Melbourne’s MSU since it began operating and more than 200 patients with the most severe strokes (large vessel occlusions) have been referred by the crew for urgent clot retrieval. In fact, 54 per cent bypassed their nearest primary stroke centre to be taken straight to a comprehensive centre where surgery could be performed. This reduced the need for inter-hospital transfers and saw treatment begin in half the time, compared to a conventional ambulance response.

Early intervention delivers significant benefits to patients, especially when treatment can be given in an ambulance within the ‘stroke golden hour’ or within the first ninety minutes after a stroke.

Latest data on the MSU’s performance shows the value of taking the emergency department to the patient:

  • Patients with stroke are treated 81 minutes faster when compared to the Australian national median time (89 minutes compared to 170 minutes)
  • The MSU is able to treat patients in as little as 15 minutes after arriving on scene – thanks to the dedicated response by Ambulance Victoria paramedics and the MSU crew
  • The team treats 10 times as many patients in the Stroke Golden Hour compared to the standard hospital pathway (1.5% vs 18%)
  • On average, it takes just 18 minutes from our arrival for the patient to receive a CT scan in the back of the ambulance.

 

According to one of the authors, Professor Leonid Churilov:

“While the experience in the field in Berlin, Texas and Melbourne has shown the benefits to patients of mobile stroke units for some time, it is fantastic to publish such strong data. It’s so pleasing to be able to show evidence that supports what our crews experience on a daily basis on Melbourne’s mobile stroke unit”.

 

To view the abstract for this publication, you can click on the following link  To view other publications by members of the Australian Stroke Alliance, click here