Abstract TMP23: Mobile Stroke Unit to Mitigate Disparities in Stroke Treatment

Background: Studies have reported longer emergency department (ED) wait times and delayed stroke treatment for Black versus White patients. Minority patients also have severe stroke symptoms compared to White patients. We hypothesize that patients with acute stroke living in distressed communities will be treated faster in the Mobile Stroke Unit (MSU) than in the ED.

Methods: This is a retrospective analysis of all patients who presented to Grady Memorial Hospital from January 1 2022-December 31, 2022, and received alteplase (tPA) either in the ED (by arrival of Emergency Medical Services) or the MSU. Patients evaluated in the MSU but received tPA in the ED were excluded from the study. Stroke treatment time metrics were compared for patients from the same zip codes between the two groups.

Results: 169 patients treated with IV tPA in the ED or MSU were screened. 39 patients qualified for the study (11 MSU and 28 ED) with matching zip codes (8 zip codes were matched). 82% (32/39) were from at-risk or distressed communities. 87% (34/39) were Black, 44% male (17/39) and mean age was 63 years. The median alarm to CT time (minutes) was significantly shorter in MSU compared to ED (41 vs 79, p <0.0001). The median alarm to thrombolysis time (minutes) was significantly shorter in the MSU compared to the ED (76 vs. 115, p < 0.0001) (Figure 1).

Conclusions: Patients from distressed communities get evaluated and treated faster in the MSU compared to ED. Our results suggest that having a MSU in distressed communities that include patients at high risk of stroke can help reduce disparities in stroke care by allowing for faster diagnosis and treatment. A larger sample size is required to compare functional outcomes.