4 New Stroke Studies and Guidelines to Know

Hans-Christoph Diener, MD, PhD

April 16, 2021

This transcript has been edited for clarity.

Dear colleagues, I am Christoph Diener, a neurologist from the University of Duisburg-Essen in Germany. This month, I'd like to highlight four new publications on stroke.

Two Studies Highlight Importance of Early Diagnosis and Treatment

In the acute treatment of stroke, there is a new way to get patients into hospitals: mobile stroke units. These are ambulances equipped with CT scanning, a small laboratory, and a stroke physician. In providing these services, the goal is to shorten the time to get the patient to thrombolysis.

A study recently published in JAMA featured data from Berlin, Germany, a city with 3.5 million inhabitants and three mobile stroke units. Investigators compared outcomes among patients with acute ischemic stroke brought to the hospital with either a mobile stroke unit or a conventional ambulance (749 vs 794 patients, respectively). The groups were well matched in terms of severity of stroke.

Investigators showed that use of a mobile stroke unit significantly improved outcome at 3 months, as measured by modified Rankin ScaleMobile stroke units reduced the time to thrombolysis by approximately 30 minutes. The rate of thrombectomy was the same between the groups, which is not surprising given that how a patient gets to the hospital is independent for this outcome. Given that mobile stroke units represent an expensive way to get patients to a hospital, it remains unknown whether this is a cost-effective approach.

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