SAN DIEGO – Mobile stroke units are specially equipped ambulance units designed to respond and deliver treatment to stroke patients as swiftly as possible. They are outfitted with a portable CT scanner, a mobile lab, and specialized personnel, including a telemedicine unit to assist with diagnosis. If a patient is experiencing an ischemic stroke, the unit can deliver thrombolytic therapy on the spot, circumventing travel to an emergency department.
But are they cost effective? There are 13 active units in the United States, and they’re not cheap. They cost about $3.5 million to build and operate over 5 years, according to James Grotta, MD, a neurologist with the Memorial Hermann Medical Group and director of stroke research at Memorial Hermann–Texas Medical Center, both in Houston.
In a video interview at the annual meeting of the American Neurological Association, Dr. Grotta described how his group is studying the impact of mobile stroke units on time to treatment and the long-term costs and cost savings associated with them in an ongoing clinical trial that is comparing outcomes in patients eligible for tissue plasminogen activator when treated by a mobile stroke unit versus standard prehospital triage and transport by emergency medical services. The study is comparing outcomes when the mobile stroke unit and emergency medical services are the primary responders on alternating weeks. Primary outcomes include cost-effectiveness, the change in Rankin scale score from baseline to 90 days, and the diagnostic agreement between a vascular neurologist in the mobile stroke unit and a telemedicine vascular neurologist consulted from the unit.
Mobile stroke units can even supplement existing health care in case of an emergency. Dr. Grotta also recounted how one unit assisted during the aftermath of Hurricane Harvey.