UCHealth’s Mobile Stroke Unit saving lives, study shows

EL PASO COUNTY, Colo. (KRDO) -- UCHealth’s Mobile Stroke Treatment Unit, which operates in both Aurora and Colorado Springs, was part of a national study that found stroke patients cared for in mobile stroke units were treated faster and had better long-term health outcomes compared to those who were transported and received care from standard emergency medical services. The findings were published Wednesday in the New England Journal of Medicine.

Mobile stroke units (MSUs) are special emergency response vehicles equipped with a CT scanner, lab testing equipment, and personnel specifically trained to diagnose and treat stroke patients. The units also have a two-way visual communication system that allows a neurologist at a hospital to examine, diagnose and recommend treatment for patients. The neurologist is able to read brain scans in real-time and determine whether t-PA, a medication that dissolves clots in the brain, is appropriate. When recommended, t-PA treatment can begin in the MSU and continue during transport to a hospital.

The study involved 1,047 patients who were eligible to receive t-PA and included mobile stroke units in six other cities: Houston, Memphis, New York, Indianapolis, Los Angeles, and Burlingame, California. About 100 patients from Colorado were included. The most striking result of the study: Patients treated with tPA in a mobile stroke unit were nearly two-and-a-half times more likely to have a good outcome – either no lingering symptoms at all or no significant disability despite symptoms – than those rushed by ambulance to a hospital, diagnosed there, and given tPA.

“Each and every day, the stroke specialists, nurses and mobile stroke unit teams are focusing on providing the fastest and highest quality care possible for patients, and mobile stroke treatment units are key to expediting such treatment. This study shows MSUs are saving lives and improving outcomes, and I hope the study encourages more hospitals to invest and expand their programs,” said Dr. William Jones, an investigator in the trial, medical director of telestroke and the mobile stroke treatment unit at UCHealth and associate professor of neurology at University of Colorado School of Medicine.

Among the findings:

• Patients treated in MSUs received the clot-busting medication t-PA about 35 minutes faster than those in the EMS group.
• More eligible patients were treated on MSUs (97%) than by standard EMS/hospital care (80%).
• The MSUs saved lives. The study found mortality at 90 days was 8.9% among those treated by the MSU, and 11.9% among patients treated and transported by traditional EMS.
• Overall health outcomes at 90 days were better for MSU patients.

“We have long known that ‘time is brain’ when it comes to treating stroke. Large numbers of brain cells die each minute they are deprived of oxygen,” said Dr. Janice Miller, a stroke specialist at UCHealth Memorial Hospital in Colorado Springs and investigator in the trial. “The MSU study has clearly shown that the time saved by bringing stroke treatment into the homes, workplaces and other locations in our community makes a positive difference in a stroke patient’s outcome and ability to return home after a stroke. This study is indebted to our many patients who agreed to participate, and to our EMS community for their enthusiastic support.”

UCHealth’s Mobile Stroke Treatment Unit splits time between Aurora and Colorado Springs. In Aurora, the unit has been dispatched 1,440 times since 2016; in Colorado Springs, the unit has been dispatched 2,160 times. Hundreds of those patients needed to be transported to the hospital, with about 170 patients receiving tPA.

Both Memorial Hospital Central in Colorado Springs and University of Colorado Hospital in Aurora have been designated as Comprehensive Stroke Centers, which are able to provide the highest level of stroke care. Strokes are the No. 5 cause of death and the leading cause of disability in the United States, according to the American Stroke Association. Deficits include the inability to recognize people, immobility, loss of vision and language impairment.

A stroke occurs when a blood vessel to the brain is either blocked by a clot (called an ischemic stroke) or ruptures (called a hemorrhagic stroke). When that happens, part of the brain cannot get the blood and oxygen it needs, causing brain cells to die. About 87% of strokes are ischemic strokes, according to the Centers for Disease Control and Prevention.

It is important for everyone to know the signs of stroke and call 911 immediately if a stroke is suspected. Learn more about the signs of stroke today.