Mobile Stroke Units Facilitate Prehospital Management of Intracerebral Hemorrhage

Stroke. 2021 Oct;52(10):3163-3166. doi: 10.1161/STROKEAHA.121.034592. Epub 2021 Jun 30.

Abstract

Background and purpose: Mobile stroke units (MSUs) improve reperfusion therapy times in acute ischemic stroke (AIS). However, prehospital management options for intracerebral hemorrhage (ICH) are less established. We describe the initial Melbourne MSU experience in ICH.

Methods: Consecutive patients with ICH and AIS treated by the Melbourne MSU were included. We describe demographics, proportions of patients receiving specific therapies, and bypass to comprehensive/neurosurgical centers. We also compare operational time metrics between patients with MSU-ICH and MSU-AIS.

Results: During a 2-year period, the Melbourne MSU managed 49 patients with ICH, mean (SD) age 74 (12) years, median (interquartile range) National Institutes of Health Stroke Scale 17 (12–20). Intravenous antihypertensives were the commonest treatment provided (46.9%). Bypass of a primary center to a comprehensive center with neurosurgical expertise occurred in 32.7% of patients with MSU-ICH compared with 20.5% of patients with MSU-AIS. Compared with patients with MSU-AIS, patients with MSU-ICH had faster onset-to-emergency-call, and onset-to-scene-arrival times at the median and 75th percentiles.

Conclusions: MSUs can facilitate ultra-early ICH diagnosis, management, and triage.

Keywords: benchmarking; cerebral hemorrhage; demographics; reatment; triage.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Ambulances*
  • Antihypertensive Agents / therapeutic use
  • Case Management
  • Cerebral Hemorrhage / therapy*
  • Emergency Medical Services / methods*
  • Female
  • Hemorrhagic Stroke / surgery
  • Hemorrhagic Stroke / therapy*
  • Humans
  • Male
  • Middle Aged
  • Neurosurgical Procedures / statistics & numerical data
  • Time-to-Treatment
  • Triage
  • Victoria

Substances

  • Antihypertensive Agents