Mobile stroke teams offer survival benefit compared to transferring patients, study finds

Stroke patients who were treated by a mobile interventional stroke team were nearly twice as likely to be functionally independent three months after their stroke compared to patients who were transferred to a specialized stroke center, according to research published Aug. 5 in Stroke

The findings emphasize the importance of timely care after stroke symptom onset, researchers said. 

The study, based on a pilot program at New York City-based Mount Sinai health system, involved 226 patients who had a stroke between January 2017 and February 2020. 

A total of 106 patients were treated by a mobile interventional stroke team, or MIST, which consisted of a neuro-interventionalist, fellow in training or a physician assistant, and a radiologic technologist. The team of Mount Sinai stroke specialists traveled to the patient's location to perform an endovascular thrombectomy — the standard of care procedure for acute ischemic stroke patients. 

Fifty-four percent who were treated within six hours of stroke symptom onset by the MIST team were functionally independent, meaning they were mobile and could perform daily tasks, 90 days after the stroke. At the same time, 28 percent of transferred patients had a good 90-day functional outcome, findings showed. 

Patients who received emergency stroke surgery from the mobile team also had better functional outcomes at discharge compared to transferred patients. 

If treated after six hours of symptom onset, the stroke patients had similar 90-day functional outcomes, regardless of whether they were seen by the MIST group or transferred to a specialized stroke center. 

"Less than 50 percent of Americans have direct access to endovascular thrombectomy, the others must be transferred to a thrombectomy-capable hospital for treatment, often losing over two hours of time to treatment," said Johanna Fifi, MD, study co-author and associate professor of neurosurgery, neurology and radiology at the Icahn School of Medicine at Mount Sinai. "Every minute is precious in treating stroke, and getting to a center that offers thrombectomy is very important. The MIST model would address this by providing access to this potentially life saving, disability-reducing procedure." 

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