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. 2025 Aug 25.
doi: 10.1007/s10072-025-08449-4. Online ahead of print.

Mobile stroke unit treatment times and transport frequency in a suburban setting

Alejandro Vargas  1 , Rebecca Zobel  2 , Laurel J Cherian  2 , Rima M Dafer  2 , Nicholas D Osteraas  2 , Sarah Y Song  2 , Mark E Cichon  3 , James J Conners  2
Affiliations

Mobile stroke unit treatment times and transport frequency in a suburban setting

Alejandro Vargas et al. Neurol Sci. .

Abstract

Background: The majority of Mobile Stoke Units (MSUs) operate in European and United States urban cities. Questions remain on the cost-effectiveness, setting (urban, suburban, or rural), infrastructure and support, and reimbursement of these units. We present our experiences of a single-center MSU in a suburban setting, with treatment times, challenges, and possible future directions of alternative methods of care.

Methods: Retrospective analysis of prospectively collected data from Mobile Stroke Unit calls for service and Get With The Guidelines-Stroke data from two primary stroke centers from December 2017 through February 2020 comparing patients receiving intravenous thrombolysis and treatment times.

Results: There were no differences in age, sex, medical history, or stroke severity between MSU transport when compared to standard transport. There were differences in patient racial and ethnic demographics between groups, with higher white race and Hispanic ethnicity. Door-to-needle time was 48.9 min for patients seen on the Rush MSU versus 67.2 min for patients seen via traditional EMS transport (p = 0.04).

Conclusions: The Rush MSU demonstrated significant reduction of acute ischemic stroke treatment time with intravenous thrombolysis, but did not demonstrate the patient volume necessary to justify continued operation. Suburban and rural regions do benefit from pre-hospital stroke evaluation, however the ideal method for a cost-effective strategy is still unknown.

Keywords: Acute ischemic stroke; Mobile stroke units; Telestroke; Thrombolysis.

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Conflict of interest statement

Declarations. Competing interests: All authors state there are no relevant disclosures or conflicts of interests. Ethical approval: This retrospective chart review study involving human participants was in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study protocol was approved by the Institutional Review Board at Rush University Medical Center. The study protocol was approved by the Institutional Review Board of Rush University Medical Center. Informed consent: There was no informed consent necessary as the Rush Mobile Stroke Unit service was deployed in Illinois Region 8 Emergency Medical Services to provide emergency care.

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