HOUSTON (March 17, 2021)

Patients received the clot-busting medication tissue plasminogen activator (tPA) faster, more often and recovered significantly better when treated via a mobile stroke unit (MSU) compared to standard management by Emergency Medical Services (EMS), according to research announced today at the International Stroke Conference.

The research was led by James Grotta, MD, director of stroke research at the Clinical Institute for Research and Innovation at Memorial Hermann-Texas Medical Center (TMC), director of the Houston Mobile Stroke Unit Consortium, and neurologist with the Memorial Hermann Medical Group, and his team with The University of Texas Health Science Center at Houston (UTHealth).  The research also resulted from the cooperation of Houston, Bellaire, and West University Fire Departments, and participation of all stroke centers in Houston.

“Receiving tPA within the first hour after the onset of stroke symptoms is critical to improving a patient’s outcome. Because the MSU is able to bring stroke treatment to the patient rather than awaiting arrival to the emergency department, we were able to treat one-third of the patients within that time frame compared to only 3 percent of those receiving standard management,” said Grotta. “We also were able to treat 97 percent of eligible patients transported by a MSU, compared to 80 percent brought to the emergency department by ambulance.”

Researchers found 53 percent of patients treated by a MSU made a complete recovery from their stroke after three months compared to 43 percent of patients not treated on a mobile stroke unit. These findings provide evidence that the earlier stroke treatment begins, especially within the first hour after it occurs, the more responsive the brain and blood clots are to effective treatment. 

“This underscores the importance of patients and bystanders to be aware of the signs of a stroke and to call 911 immediately,” said Grotta.

The research is part of the ongoing BEST-MSU study and examined data from more than 1,000 patients who suffered an ischemic stroke and were eligible at seven centers which included Houston, between 2014 and 2020.

In 2014, McGovern Medical School at UTHealth in partnership with Memorial Hermann-TMC was the first in the nation to launch a mobile stroke unit, a specially equipped ambulance for diagnosing and treating stroke rapidly before hospital arrival.  According to the Centers for Disease Control and Prevention, stroke is the fifth leading cause of death in the United States and a major contributor to long-term disability and in the United States, someone has a stroke every 40 seconds. Approximately 87 percent of all strokes are ischemic strokes, in which blood flow to the brain is blocked, and they are amenable to treatment with tPA.

“Given our positive results, we think that more widespread deployment of mobile stroke units would have a public health impact on reducing disability from stroke,” Grotta added.

More research is ongoing by Grotta and the team at UTHealth to assess healthcare utilization over the entire year following a patient’s stroke, which will enable a better idea of the cost effectiveness of mobile stroke unit implementation on a wider scale.

The study was supported by the Patient Centered Outcomes Research Institute, the American Heart Association and Genentech.