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Cerebrovasc Dis ; 50(5): 520-525, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34175842

RESUMEN

BACKGROUND AND PURPOSE: Most patients cannot receive intravenous thrombolytic therapy in the early stage of stroke onset, and the application of mobile stroke unit (MSU) in prehospital intravenous thrombolytic therapy of acute stroke may change this situation. The first MSU in China was put into use in 2017. Herein, we aimed to explore the preliminary experience of MSU in prehospital thrombolysis of acute stroke. METHODS: Patients who received prehospital intravenous thrombolytic therapy using MSU were classified to the MSU thrombolysis group, and the control group consisted of stroke patients admitted by regular ambulances, who were transferred to hospital for intravenous thrombolytic therapy. The feasibility, safety, and duration of procedures were compared. RESULTS: There were 14 patients received prehospital intravenous thrombolysis on the MSU, and 24 patients underwent intravenous thrombolysis in the emergency center, who were transferred by the ordinary ambulance during the same period. The median call-to-needle time was 59.5 min in the MSU thrombolysis group, while it was 89 min in the control group; the difference between the 2 groups was statistically significant (p = 0.001). The median time from onset to thrombolysis was 70 and 102.5 min, respectively, in the 2 groups (p = 0.002). The percentages of good clinical outcome (modified Rankin Scale score ≤ 2) at 90-day follow-up were 79 and 67%, respectively (p = 0.488). The rate of symptomatic intracranial hemorrhage and mortality during the perioperative period did not differ significantly between 2 groups. CONCLUSION: Despite the small sample size, our preliminary experience of the application of MSU in the prehospital thrombosis therapy seems to indicate a significant reduction in time from call to needle, the efficacy of MSU in the treatment of acute stroke needs further experiment and larger sample size to confirm.


Asunto(s)
Servicios Médicos de Urgencia , Fibrinolíticos/administración & dosificación , Accidente Cerebrovascular Isquémico/tratamiento farmacológico , Unidades Móviles de Salud , Terapia Trombolítica , Adulto , Anciano , Anciano de 80 o más Años , China , Evaluación de la Discapacidad , Estudios de Factibilidad , Femenino , Fibrinolíticos/efectos adversos , Humanos , Accidente Cerebrovascular Isquémico/diagnóstico , Accidente Cerebrovascular Isquémico/fisiopatología , Masculino , Persona de Mediana Edad , Recuperación de la Función , Estudios Retrospectivos , Terapia Trombolítica/efectos adversos , Factores de Tiempo , Tiempo de Tratamiento , Resultado del Tratamiento
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