Stroke: Vascular and Interventional Neurology (Mar 2023)

Abstract Number ‐ 153: Mobile stroke units in acute ischemic stroke: A comprehensive meta‐analysis of nineteen controlled trials

  • Mohamed F Doheim,
  • Abdulrahman Ibrahim Hagrass,
  • Mohammed Al‐kafarna,
  • Mohamed Abdelhady Mostafa,
  • Mohamed Elfil,
  • Sarah Makram Elsayed,
  • Aya Mamdouh Fayoud,
  • Aboalmagd Hamdallah,
  • Mohammed Tarek Hasan,
  • Bashar Khaled Almaghary,
  • Khaled Mohamed Ragab,
  • Abdallah Kamal,
  • Fawaz Al‐Mufti

DOI
https://doi.org/10.1161/SVIN.03.suppl_1.153
Journal volume & issue
Vol. 3, no. S1

Abstract

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Introduction In certain circumstances, mobile stroke units (MSU) with on‐site treatment teams and a computed tomography scanner may offer faster therapy with tissue plasminogen activator (tPA) for stroke patients who need immediate treatment. We conducted a systematic review and meta‐analysis to compare clinical outcomes in MSU patients to those in conventional care. Methods We searched key electronic databases from inception till September 2021. The primary outcomes were mortality at 7 days and 90 days. The secondary outcomes included modified Rankin scale (mRS) at 90 days, alarm to intravenous thrombolysis (IVT) or intra‐arterial recanalization, and time from symptom onset or last known well (LKW) to thrombolysis. Results We included nineteen controlled trials and cohort studies to conduct our final analysis. Our comparison revealed that 90‐day mortality rate significantly declined in MSU group as compared to conventional care group (OR = 0.81, 95%CI [0.69,0.95]), while there was no significant difference at 7 days (OR = 0.88, 95%CI [0.68,1.15]). As regard achieving functional independence at 90 days (mRS = 0–2), MSU showed better results (OR = 1.24, 95%CI [1.03,1.49]). MSU was associated with shorter time from symptoms onset or LKW to thrombolysis (MD = ‐36.79, 95%CI [‐47.48, ‐26.10]) and alarm to IV thrombolysis or intra‐arterial recanalization (MD = ‐29.69, 95%CI [‐34.46, ‐24.92]). Conclusions Stroke patients treated in MSU had a lower incidence of the 90‐day mortality. They also had better functional independence at 90 days and time from symptom onset or LKW to thrombolysis than those treated with conventional care.