Objective:

To determine how implementing mobile stroke units (MSUs) affects functional, safety, and temporal outcomes during acute stroke care, and to examine the necessity of having a neurologist onboard for MSU implementation.

Approach:

• Study Design: Systematic review and meta-analysis of randomized and non-randomized controlled trials.
• Data Sources: Literature search conducted across multiple databases including PubMed, MEDLINE, Scopus, Web of Science, and the Cochrane Library.
• Inclusion Criteria: Studies involving patients with suspected acute stroke managed through MSUs versus EMS, reporting at least one predefined main outcome.

Key Findings:

• MSU intervention reduced the pooled median time by 26.3 minutes compared to control (p < 0.001).
• No significant difference in outcomes was found between onboard and remote neurologist configurations (p = 0.7241).
• Safety endpoints for intracerebral hemorrhage and mortality showed no significant pooled odds ratios: ICH, 1.019 [95% CI (0.71,1.45), p = 0.918]; and mortality, 1.23 [95% CI (0.85, 1.77), p = 0.271].

Limitations:

• Variation among trial designs and inconsistent definitions of important time intervals.
• Previous studies often had small sample sizes and insufficient comprehensive outcome assessments.

Sources:

• Systematic Review Registration