Diurnal Variations in the First 24/7 Mobile Stroke Unit

Stroke. 2019 Jul;50(7):1911-1914. doi: 10.1161/STROKEAHA.119.024950. Epub 2019 May 20.

Abstract

Background and Purpose- Mobile Stroke Units (MSUs) provide innovative prehospital stroke care but their 24/7 operation has not been studied. Our study investigates 24/7 MSU diurnal variations related to transport frequency, patient characteristics, and stroke treatments. Methods- We compared transportation frequency, demographics, thrombolytic and mechanical thrombectomy administration, and treatment metrics across 8-hour shifts (morning, evening, and nocturnal) from our 24/7 MSU in Northwest Ohio prospective database. Results- One hundred ninety-five patients were transported by the MSU. Most transports occurred during the morning shift (52.3%) followed by evening shift (35.8%) and nocturnal shift (11.9%; Ptrend<0.001). Twenty-three patients (11.9%) received intravenous thrombolytic in the MSU, most frequently in the morning shift (56.5%). No cases of mechanical thrombectomy were performed on MSU patients in the nocturnal shift. Conclusions- Morning and evening shifts account for the majority of our MSU transports (88.1%) and therapeutic interventions. Understanding temporal variations in a resource-intensive MSU is critical to its worldwide implementation.

Keywords: diurnal variation; mobile stroke unit; prehospital stroke; stroke; system of care.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Brain Ischemia / drug therapy
  • Databases, Factual
  • Emergency Medical Services / statistics & numerical data
  • Female
  • Humans
  • Male
  • Middle Aged
  • Mobile Health Units / statistics & numerical data*
  • Ohio / epidemiology
  • Socioeconomic Factors
  • Stroke / epidemiology
  • Stroke / therapy*
  • Thrombectomy
  • Thrombolytic Therapy
  • Time Factors
  • Tissue Plasminogen Activator / therapeutic use
  • Transportation of Patients

Substances

  • Tissue Plasminogen Activator