Charité researchers present a new study on the use of stroke emergency mobile ambulance

Is prehospital stroke treatment associated with better outcomes?

Berlin, Germany (August 25, 2016) – When treating a patient with stroke, every minute counts. A specialized stroke ambulance (Stroke Emergency Mobile or STEMO) allows physicians to start specific treatment, such as thrombolysis, at scene. A recent study conducted by researchers from Charité – Universitätsmedizin Berlin investigated whether this earlier response time leads to an improved prognosis. Patients who received the appropriate treatment during transfer to the hospital were less likely to have a disability three months after their stroke than patients who received conventional treatment. Although the difference in surviving without any disability slightly failed to reach the predefined level of significance, other outcomes such as severe disability or death were also more favorable in the STEMO group. Results from this study have been published in the journal The Lancet Neurology*.

Approximately 90% of strokes are ischemic strokes, i.e. they are caused by a blood clot blocking an artery in the brain. Arterial blockages of this kind can be dissolved by thrombolytic therapy. However, approximately 10% of strokes are caused by bleeding inside the brain (hemorraghic stroke). As such bleedings would be unstoppable under thrombolytic therapy, it is essential to exclude cerebral bleedings before starting treatment. Physicians achieve this by using computed tomography (CT) for brain scanning, usually in hospital.

Led by Prof. Dr. Heinrich Audebert, clinical lead of the Department of Neurology at Campus Benjamin Franklin, the researchers studied whether early thrombolytic therapy influences the patient’s subsequent degree of disability. This was done by comparing the outcomes of patients who received thrombolysis after being transported to hospital in a conventional emergency vehicle and those patients who received thrombolysis already inside the STEMO. Patients from both groups had their degree of disability assessed three months after stroke.

"Our results suggest that earlier thrombolysis, delivered in STEMO already before hospital arrival, results in fewer disabilities that affect daily living, and in better survival rates," says the study’s first author, Dr. Alexander Kunz. He adds: "The earlier acute stroke treatment starts, the better the outcomes. Data from our study suggest that, wherever possible, treatment should commence prior to arrival at hospital." Early treatment of this type is made possible through specially-equipped mobile stroke treatment units, such as the STEMO, which is jointly operated by the Berlin Fire Department and the Center for Stroke Research Berlin. The ambulance, that is equipped with a CT scanner and a mini-laboratory, is staffed by a neurologist who is also trained in emergency medicine. A previous study by the Charité researchers had shown that patients treated in the STEMO received potentially life-saving thrombolysis on average by 25 minutes earlier compared to patients who were admitted by conventional ambulance and treated after hospital arrival.

  • *Kunz A, Ebinger M, Geisler F, Rozanski M, Waldschmidt C, Weber JE, Wendt M, Winter B, Zieschang K, Fiebach JB, Villringer K, Erdur H, Scheitz JF, Tütüncü S, Bollweg K, Grittner U, Kaczmarek S, Endres M, Nolte CH, Audebert HJ. Functional outcomes of pre-hospital thrombolysis in a mobile stroke treatment unit compared with conventional care: an observational registry study. Lancet Neurol 2016; 15: 1035-1043. doi: 10.1016/S1474-4422(16)30129-6.

Links


Charité – Universitätsmedizin Berlin , 25.08.2016 (tB).

MEDICAL NEWS

Inadequate sequencing of SARS-CoV-2 variants impedes global response to COVID-19
New meta-analysis finds cannabis may be linked to development of…
New guidance on how to diagnosis and manage osteoporosis in…
Starting the day off with chocolate could have unexpected benefits
Better mental health supports for nurses needed, study finds

SCHMERZ PAINCARE

Versorgung verbessern: Deutsche Gesellschaft für Schmerzmedizin fordert die Einführung des…
Pflegeexpertise im Fokus: Schmerzmanagement nach Operationen
Versorgung verbessern: Bundesweite Initiative der Deutschen Gesellschaft für Schmerzmedizin zu…
Jedes vierte Kind wünscht bessere Schmerzbehandlung
Lebensqualität von Patienten in der dauerhaften Schmerztherapie mit Opioiden verbessern

DIABETES

Bundestag berät über DMP Adipositas: DDG begrüßt dies als Teil…
Mit der Smartwatch Insulinbildung steuern
Verbände fordern bessere Ausbildung und Honorierung von Pflegekräften für Menschen…
Minimalinvasive Geräte warnen ungenügend vor Unterzuckerung
Typ-1-Diabetes und Hashimoto-Thyreoiditis treten häufig gemeinsam auf

ERNÄHRUNG

Wie eine Diät die Darmflora beeinflusst: Krankenhauskeim spielt wichtige Rolle…
DGEM plädiert für Screening und frühzeitige Aufbautherapie: Stationäre COVID-19-Patienten oft…
Führt eine vegane Ernährungsweise zu einer geringeren Knochengesundheit?
Regelmässiger Koffeinkonsum verändert Hirnstrukturen
Corona-Erkrankung: Fehl- und Mangelernährung sind unterschätze Risikofaktoren

ONKOLOGIE

Anti-Myelom-Therapie mit zusätzlich Daratumumab noch effektiver
Positive Ergebnisse beim fortgeschrittenen Prostatakarzinom: Phase-III-Studie zur Radioligandentherapie mit 177Lu-PSMA-617
Lymphom-News vom EHA2021 Virtual. Alle Berichte sind nun online verfügbar!
Deutsch-dänisches Interreg-Projekt: Grenzübergreifende Fortbildungskurse in der onkologischen Pflege
Sotorasib: Neues Medikament macht Lungenkrebs-Patienten Hoffnung

MULTIPLE SKLEROSE

NMOSD-Erkrankungen: Zulassung von Satralizumab zur Behandlung von Jugendlichen und Erwachsenen
Verzögerte Verfügbarkeit von Ofatumumab (Kesimpta®)
Neuer Biomarker bei Multipler Sklerose ermöglicht frühe Risikoeinschätzung und gezielte…
Multiple Sklerose beginnt oft lange vor der Diagnose
Goldstandard für Versorgung bei Multipler Sklerose

PARKINSON

Meilenstein in der Parkinson-Frühdiagnose
Parkinson-Erkrankte besonders stark von Covid-19 betroffen
Gangstörungen durch Kleinhirnschädigung beim atypischen Parkinson-Syndrom
Parkinson-Agenda 2030: Die kommenden 10 Jahre sind für die therapeutische…
Gemeinsam gegen Parkinson: bessere Therapie durch multidisziplinäre Versorgung