Methodology: 2.5 5
Usefulness: 2.5/5

Grotta JC, et al. N Engl J Med. 2021 Sep 9;385(11):971-981. doi: 10.1056/NEJMoa2103879.

Question and Methods: This study investigated if mobile stroke units (MSU) alter outcomes when compared to standard management by emergency medical services (EMS) using an observational, prospective, multicenter, alternating week trial.
Findings: The mean score on the utility weighted modified Rankin scale at 90 days in patients eligible for tPA was 0.72 in the MSU group and 0.66 in the EMS group (OR 2.4, CI 1.75 – 3.36, p<0.001) indicating less disability in patients within the MSU group.
Limitations: Major limitations of this study included nonrandomized design, change in primary analysis and highly selective population.

Interpretation: Despite this positive trial, additional research such as a cost analysis and generalizability to our current geography would be necessary prior considering implementation.

Dr. Maria Doubova

Author

  • Dr. Rosenberg is an emergency physician at the Ottawa Hospital, assistant professor at the University of Ottawa, and Director of the Digital Scholarship and Knowledge Dissemination Program.