DEPLOYMENT OF MOBILE STROKE UNITS FOR TIMELY ACCESS TO DIAGNOSIS AND TREATMENT OF ISCHEMIC STROKES: A SCOPING REVIEW giftdansu30@gmail.com

 

DEPLOYMENT OF MOBILE STROKE UNITS FOR TIMELY ACCESS TO DIAGNOSIS AND TREATMENT OF ISCHEMIC STROKES: A SCOPING REVIEW

7

Nigeria

Oral or Poster

Mobile stroke units (MSUs) are prehospital care facilities with the ability to diagnose and treat ischemic strokes en route to a specialized stroke hospital. MSUs could have the potential to improve outcomes after stroke for patients in low-resource settings with limited access to stroke care.

A scoping review was conducted according to PRISMA-ScR guidelines. Full-text publications with data on MSUs were included.

47 studies with 24,610 patients (47.1% female) met inclusion criteria. Only one study was published with data from a low-middle income country (Thailand). The remaining 46 studies were published with data from high-income countries, primarily in high-resource urban settings. Average age was 70 years (range: 20-105 years). 91.7% of patients were found to have ischemic strokes, and 2960 patients were treated with intravenous or intra-arterial thrombolysis on the MSU. Average time from symptom onset to MSU arrival was 39.2 minutes, time from symptom onset to neuroimaging was 41.1 minutes, and time from symptom onset to administration of fibrinolysis was 78.9 minutes. The rate of administration of reperfusion therapy in the setting of hemorrhagic stroke on MSUs was comparable to the rate in stroke care centers and was minimal.

MSUs have been deployed in high-resource settings with improvements in ischemic stroke diagnosis and treatment. There is an extreme paucity of data regarding the deployment of MSUs in low-resource settings, and future research should focus on their utilization in low-middle income countries to improve timely access to neuroimaging and reperfusion therapies.