Mobile stroke units based on rural emergency medical stations for pre-hospital intravenous thrombolysis of stroke in remote areas.

Abstract

Objectives: To explore a novel model of mobile stroke units (MSUs) integrated with rural emergency medical stations for pre-hospital care of stroke patients in remote areas.

Methods: We used MSUs + Ambulance mode, where both the MSUs and conventional ambulances are sent to the patient's location. The conventional ambulance coordinates with the MSUs to choose the fastest route to meet and transfer the patient at the point along the way. We collected data from 149 patients from March 2022 to April 2023, including National Institutes of Health Stroke Scale (NIHSS) scores (on admission, 24 hours, day 7), 90-day modified Rankin Scale (mRS) scores, and other clinical variables. We performed propensity score matching (PSM) to balance the potential confounding variables between groups.

Results: We found that the MSUs + Ambulance mode (OR = 12.507, 95% confidence interval [CI] [3.633, 43.061], p < 0.001) and admission NIHSS score (OR = 0.583, 95% CI [0.493, 0.690], p < 0.001) were independent prognostic risk factors for stroke patients. The MSUs + Ambulance mode reduced NIHSS scores 7 days prior to admission (OR = 0.679, 95% CI [0.563, 0.819], p < 0.001). After PSM, patients who received MSUs + Ambulance mode had a better prognosis (χ² = 9.573, p = 0.004), as well as a lower mRS score at 90 days (Z = -3.371, p = 0.001).

Conclusions: MSUs integrated with rural emergency medical stations show the feasibility and potential benefits of pre-hospital intravenous thrombolysis for stroke patients in geographically distant regions.