Mobile Stroke Units Linked to Improved OutcomesAmong Patients WithAcute Ischemic Stroke

This retrospective study included 19,433 patients with acute ischemic stroke (median age, 73 years; 50.8% women) from 106 US hospitals between 2018 and 2023 who were potentially eligible for intravenous thrombolysis and received prehospital care from mobile stroke units (n = 1237) or standard EMS (n = 18,196).
The primary outcome was the level of global disability at discharge measured using utility-weighted modified Rankin Scale (UW-mRS) scores, with higher scores indicating better quality of life.
The secondary outcome was independent ambulation at discharge, and the safety endpoints were symptomatic intracranial hemorrhage and in-hospital death.

Patients who received prehospital treatment in mobile stroke units had better global disability scores than those who received standard EMS management (mean score, 0.51 vs 0.47; adjusted mean difference, 0.03), along with higher rates of nondisabled outcomes (mRS 0-1) and functional independence (mRS 0-2) at discharge.
Patients who were treated in mobile stroke units showed higher rates of independent ambulation at discharge than those who received standard EMS care (53.3% vs 48.3%; adjusted relative risk (aRR), 1.08; 95% CI, 1.03-1.13).
Patients who received mobile stroke unit care were more likely to be treated with intravenous thrombolysis than those who received standard EMS care (84.6% vs 66.4%; aRR, 1.26; 95% CI, 1.22-1.29), with a shorter time to thrombolysis initiation (103 vs 119 minutes).
The rates of symptomatic intracranial hemorrhage and in-hospital mortality were not significantly different between the two groups.

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Mobile Stroke Units Linked to Improved OutcomesAmong Patients WithAcute Ischemic Stroke Patients with acute ischemic stroke treated in mobile stroke units have better outcomes, with lower global disability scores, faster thrombolysis times, and comparable safety outcomes, than those receiving standard emergency medical services (EMS) care.

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