Abstract TP296: Superior Clinical Outcome (mRS 0-1) in Thrombectomy Patients Better Achieved with Mobile Stroke Facilitation

Background: We sought to compare superior clinical outcomes, modified Rankin Score (mRS) 0-1, after thrombectomy in patients facilitated by a mobile stroke unit (MSU) versus traditional emergency room presentation. Methods: The Mobile Stroke Treatment Unit of metropolitan Columbus, Ohio, provides emergency stroke care coverage for 445 square miles spanning over 50 zip codes. Our MSU is operational from 0700-1900 daily and is dispatched for all 911 calls designated as probable or likely strokes. We retrospectively reviewed patients from January 2021 to June 2024 who received mechanical thrombectomy for an occlusion of the vertebral/basilar artery, intracranial internal carotid artery, or middle cerebral artery M1 or M2 segments. Patients were either facilitated by our MSU or through traditional EMS. We compared our MSU cohort with traditional EMS facilitated patients during the same operational hours and by the same regional EMS. Our endpoint was superior clinical outcome for thrombectomy defined as mRS 0-1 at 90 days. We performed a single tail Fisher’s test to determine a statistical difference between the two cohorts. Results: The MSU cohort included 57 patients (41% male), and the EMS cohort included 38 (53% male) patients. Mean NIHSS score for all patients was 17 (+/- 10). In the MSU cohort, 24 patients (42.0%) achieved a superior clinical outcome while 9 (23.6%) achieved this outcome in the EMS group (OR 2.1, p=0.05). Of note, 26 MSU facilitated patients (47%) received thrombolytics while 8 (21%) patients transported via EMS received thrombolytics. Conclusion: Our study suggests that MSU involvement leads to better qualitative outcomes with thrombectomy compared to traditional EMS presentation. This may be due to the anticipation of a known, likely large vessel occlusion patient. Prospective study with multiple centers is needed to further validate the value of MSUs in systems of stroke care.