Abstract Details

Title Mobile Stroke Units in Acute Ischemic Stroke: A Network Meta-analysis

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) S35 - Cerebrovascular Disease: Meta-analyses and Outcomes Research (2:12 PM-2:24 PM)

Poster/Presentation
Number 007

Objective

We performed a systematic review and network meta-analysis to evaluate the clinical outcomes in patients treated at mobile stroke units (MSU) compared to conventional care.

Background

In some circumstances, MSU with on-site treatment teams and a computed tomography scanner may offer faster therapy with tissue plasminogen activator for stroke patients who needed immediate treatment than do emergency medical services.

Design/Methods We searched key electronic databases from inception till September 2021. The primary outcomes were mortality after 7 days and 90 days. The secondary outcomes Included; modi?ed Rankin scale (mRS) after 90 days, alarm to IV thrombolysis or intra-arterial recanalization (min).

Results We included eighteen controlled trials and cohort studies to conduct our final analysis. Our network comparison found that mortality rate after 90 days significantly reduced in MSU more than Conventional Care (RR = 1.49, 95% CI [1.11; 1.99]), while there was no significant difference after seven days in MSU comparing to hospital, traditional ambulance, and conventional care (RR = 0.38, 95% CI [0.08; 1.77]), (RR = 0.78, 95% CI [0.30; 2.05]), (RR = 1.73, 95% CI [0.71; 4.23]) respectively. Our network comparisons between different therapies after 90 days detected that the mRS score was significantly improved in MSU comparing to hospital, and optimized prehospital management (OPM) (MD = -0.67, 95% CI [-1.32; -0.02]), (MD = -1.67, 95% CI [-2.67; -0.67]) respectively. Regarding Alarm to IV thrombolysis or intra-arterial recanalization, our analysis found that MSU was superior to traditional ambulance, and hospital (MD = -36.83, 95% CI [-43.04; -30.62]), (MD = -37.33, 95% CI [-44.73; -29.93]) respectively.

Conclusions Stroke patients treated with MSU had a lower incidence of 90 days mortality. They also had better functional independence after 90 days and alarm to IV thrombolysis or intra-arterial recanalization time than those treated with conventional care.

Authors/Disclosures
Mohamed Fahmy Doheim (University of Pittsburgh) PRESENTER	Mr. Doheim has nothing to disclose.
Abdulrahman I. Hagrass, MBBS	Mr. Hagrass has nothing to disclose.
	No disclosure on file
	No disclosure on file
Aboalmagd Hamdallah	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
Mohamed A. Mostafa, MD (Alexandria University)	Dr. Mostafa has nothing to disclose.

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