WSO December 2023 – Issue 3 - 1209

1185471
WSO
International Journal of StrokePirlog et al.
Research
Outcomes of patients with pre-existing
disability managed by mobile stroke
units: A sub-analysis of the BEST-MSU
study
International Journal of Stroke
2023, Vol. 18(10) 1209 -1218
© 2023 World Stroke Organization
Article reuse guidelines:
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DOI: 10.1177/17474930231185471
journals.sagepub.com/home/wso
https://doi.org/10.1177/17474930231185471
Bianca O Pirlog1 , Asha P Jacob2, Suja S Rajan3, Jose-Miguel
Yamal4, Stephanie A Parker2 , Mengxi Wang4, Ritvij Bowry5,
Alexandra Czap2, Patti L Bratina2, Michael O Gonzalez4,
Noopur Singh4 , Jinhao Zou6, Nicole R Gonzales7,
William J Jones7 , Anne W Alexandrov8, Andrei V Alexandrov8,
Babak B Navi9 , May Nour10, Ilana Spokoyny11 , Jason Mackey12,
Kelly Silnes13 , Matthew E Fink9, Carla Pisarro Sherman9,
Josh Willey14, Jeffrey L Saver10 , Joey English11, Nobl Barazangi11,
David Ornelas7, Jay Volpi15, Chethan PV Rao16, Laura Griffin17,
David Persse18 and James C Grotta19
Abstract
Background: Few data exist on acute stroke treatment in patients with pre-existing disability (PD) since they are
usually excluded from clinical trials. A recent trial of mobile stroke units (MSUs) demonstrated faster treatment and
improved outcomes, and included PD patients.
Aim: To determine outcomes with tissue plasminogen activator (tPA), and benefit of MSU versus management by emergency
medical services (EMS), for PD patients.
Methods: Primary outcomes were utility-weighted modified Rankin Scale (uw-mRS). Linear and logistic regression
models compared outcomes in patients with versus without PD, and PD patients treated by MSU versus standard
management by EMS. Time metrics, safety, quality of life, and health-care utilization were compared.
1Department of Neuroscience, County Emergency Hospital Cluj-Napoca, Cluj-Napoca, Romania
2Department of Neurology, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA
3 Department of Management, Policy and Community Health, School of Public Health, University of Texas Health Science Center at Houston,
Houston, TX, USA
4Department of Biostatistics and Data Science, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA
5Department of Neurosurgery, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA
6Department of Biostatistics, University of Texas MD Anderson Cancer Center, Houston, TX, USA
7Department of Neurology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
8Department of Neurology, College of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
9Feil Family and Brain Research Institute and Department of Neurology, Weill Cornell Medicine, New York, NY, USA
10Department of Neurology, Ronald Reagan University of California, Los Angeles Medical Center, Los Angeles, CA, USA
11Department of Neurology, Mills-Peninsula Medical Center, Burlingame, CA, USA
12Department of Neurology, Indiana University School of Medicine, Indianapolis, IN, USA
13University of Buckingham Medical School, Buckingham, UK
14Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
15Department of Neurology, Houston Methodist Neurological Institute, Houston, TX, USA
16Department of Neurology, Baylor College of Medicine, Houston, TX, USA
17HCA Houston Healthcare, Houston, TX, USA
18Department of Emergency Medicine, Baylor College of Medicine, Houston, TX, USA
19Mobile Stroke Unit, Memorial Hermann Texas Medical Center, Houston, TX, USA
Corresponding author:
Bianca O Pirlog, Department of Neuroscience, County Emergency Hospital Cluj-Napoca, 43 Victor Babeș Street, Cluj-Napoca, 400012, Romania.
Email: byanemes@gmail.com
International Journal of Stroke, 18(10)
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WSO December 2023 – Issue 3

Table of Contents for the Digital Edition of WSO December 2023 – Issue 3
