Department of Neurology, The Third People's Hospital of Hefei (The Third Clinical College of Anhui Medical University), Hefei, Anhui Province, China.
Department of Neurology, Suzhou First People's Hospital of North Anhui Health Vocational College, Suzhou, Anhui Province, China.
Neurol Res. 2024 Dec;46(12):1160-1166. doi: 10.1080/01616412.2024.2423588. Epub 2024 Oct 30.
To explore a novel model of mobile stroke units (MSUs) integrated with rural emergency medical stations for pre-hospital care of stroke patients in remote areas.
We used MSUs + Ambulance mode, where both the MSUs and conventional ambulances are sent to the patient's location. The conventional ambulance coordinates with the MSUs to choose the fastest route to meet and transfer the patient at the point along the way. We collected data from 149 patients from March 2022 to April 2023, including National Institutes of Health Stroke Scale (NIHSS) scores (on admission, 24 hours, day 7), 90-day modified Rankin Scale (mRS) scores, and other clinical variables. We performed propensity score matching (PSM) to balance the potential confounding variables between groups.
We found that the MSUs + Ambulance mode (OR = 12.507, 95% confidence interval [CI] [3.633, 43.061], < 0.001) and admission NIHSS score (OR = 0.583, 95% CI [0.493, 0.690], < 0.001) were independent prognostic risk factors for stroke patients. The MSUs + Ambulance mode reduced NIHSS scores 7 days prior to admission (OR = 0.679, 95% CI [0.563, 0.819], < 0.001). After PSM, patients who received MSUs + Ambulance mode had a better prognosis (χ = 9.573, = 0.004), as well as a lower mRS score at 90 days (Z = -3.371, = 0.001).
MSUs integrated with rural emergency medical stations show the feasibility and potential benefits of pre-hospital intravenous thrombolysis for stroke patients in geographically distant regions.
探索一种新型的移动卒中单元（MSU）与农村急救站相结合的模式，用于偏远地区卒中患者的院前救治。
采用 MSU+救护车模式，即同时派出 MSU 和常规救护车到患者所在地。常规救护车与 MSU 协调，选择最快的路线，在途中的某个点相遇并转移患者。我们收集了 2022 年 3 月至 2023 年 4 月期间 149 名患者的数据，包括国立卫生研究院卒中量表（NIHSS）评分（入院时、24 小时、第 7 天）、90 天改良 Rankin 量表（mRS）评分和其他临床变量。我们进行了倾向评分匹配（PSM）以平衡组间潜在的混杂变量。
我们发现 MSU+救护车模式（OR=12.507，95%置信区间[CI] [3.633, 43.061]， < 0.001）和入院 NIHSS 评分（OR=0.583，95% CI [0.493, 0.690]， < 0.001）是卒中患者的独立预后危险因素。MSU+救护车模式可降低入院前 7 天 NIHSS 评分（OR=0.679，95% CI [0.563, 0.819]， < 0.001）。PSM 后，接受 MSU+救护车模式的患者预后更好（χ²=9.573， = 0.004），90 天 mRS 评分更低（Z=-3.371， = 0.001）。
将 MSU 与农村急救站相结合，为地理偏远地区的卒中患者提供了院前静脉溶栓的可行性和潜在益处。
