Mobile Stroke Units Facilitate Prehospital Management of Intracerebral Hemorrhage
S. Regan Cooley, Henry Zhao, Bruce Campbell, Leonid Churilov, Skye Coote, Damien Easton, Francesca Langenberg, Michael Stephenson, Bernard Yan, Patricia Desmond, Peter Mitchell, Mark Parsons, Geoffrey A. Donnan, Stephen M. Davis, Nawaf Yassi, Karen Smith, Stephen Bernard, Dominique A. Cadilhac, Joosup Kim, Christopher F. Bladin, Douglas E. Crompton, Helen M. Dewey, Lauren Sanders, Tissa Wijeratne, Geoffrey Cloud, Duncan Mark Brooks, Hamed Asadi, Vincent Thijs, Ronil V. Chandra, Henry Ma, Thanh Phan, Andrew Bivard, Richard Dowling, Nawaf Yassi
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.