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E-110 Diurnal variability in the first 24/7 mobile stroke unit worldwide, a prospective observational study
  1. K Changal1,
  2. A Sultan-Qurraie2,
  3. V Calderon3,
  4. E Lin2,
  5. J Goins-Whitmore4,
  6. O Zaidat2
  1. 1Internal Medicine, Mercy St Vincent Medical Center, Toledo, OH
  2. 2Interventional Neurology, Mercy St Vincent Medical Center, Toledo, OH
  3. 3Neurology, Mercy St Vincent Medical Center, Toledo, OH
  4. 4EMS, Mercy St Vincent Medical Center, Toledo, OH


Background and purpose Our mobile stroke unit (MSU) is the first 24/7 MSU worldwide. This provides a unique opportunity to report the temporal variation of its transports, types of patients treated, and therapy administered on the MSU.

Methods This was a prospective, observational study conducted over the first year of the MSU’s operation. We compared different variables and metrics across the following times segments: hourly, 8 hour work shifts (morning 07:00–15:00, evening 15:01–23:00, and nocturnal 23:01–06:59), and 12 hour periods (daytime 07:00–19:00, nighttime 19:01–06:59).

Results A total of 195 patients were treated and transported by the MSU. Based on hourly segments, the majority of MSU runs occurred from 13:00 to 14:00 (10.4%). The highest rate of transport was 52.3% in the morning shift, followed by 35.8% in the evening shift, and 11.9% during the nocturnal shift. When comparing daytime to nighttime, rate of transport was 73.1% vs 26.9%, respectively. A total of 23 patients received tPA; the most frequent hourly time segment was between 13:00–14:00 (21.7%), and the least frequent period was 02:00 to 07:00 with no tPA given. Of the total tPA administered, 56.5% was given during the morning shift, 34.7% in the evening shift, and 8.6% in the nocturnal shift. Twenty (86.9%) patients received tPA during the daytime and 3 (13%) received it during nighttime runs. Only 7 patients had mechanical thrombectomy (MT), all of which were done during the daytime.

Conclusions MSU utilization varies with time of the day, with the highest rate of transport between 13:00–14:00. Higher rates of transport occur during the morning shift, compared to evening and nocturnal shifts; daytime period also has a higher rate of transport compared to nighttime period. tPA administration follows a similar trend. Staffing and utilization of a MSU can be managed more effectively if this variation is taken into account.

Abstract E-110 Figure 1

Number of MSU transports and tPA given by hour of the day

Disclosures K. Changal: None. A. Sultan-Qurraie: None. V. Calderon: None. E. Lin: None. J. Goins-Whitmore: None. O. Zaidat: None.

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