The safety and efficacy of mobile stroke units (MSUs) in prehospital stroke management has recently been investigated in different clinical studies. MSUs are ambulances equipped with a CT scanner, point-of-care lab, telemedicine and are staffed with a stroke specialised medical team. This European Stroke Organisation (ESO) guideline provides an up-to-date evidence-based recommendation to assist decision-makers in their choice on using MSUs for prehospital management of suspected stroke, which includes patients with acute ischaemic stroke (AIS), intracranial haemorrhage (ICH) and stroke mimics. The guidelines were developed according to the ESO standard operating procedure and Grading of Recommendations, Assessment, Development and Evaluation (GRADE) methodology. The working group identified relevant clinical questions, performed systematic reviews and aggregated data meta-analyses of the literature, assessed the quality of the available evidence and made specific recommendations. Expert consensus statements are provided where sufficient evidence was not available to provide recommendations based on the GRADE approach. We found moderate evidence for suggesting MSU management for patients with suspected stroke. The patient group diagnosed with AIS shows an improvement of functional outcomes at 90 days, reduced onset to treatment times and increased proportion receiving IVT within 60 min from onset. MSU management might be beneficial for patients with ICH as MSU management was associated with a higher proportion of ICH patients being primarily transported to tertiary care stroke centres. No safety concerns (all-cause mortality, proportion of stroke mimics treated with IVT, symptomatic intracranial bleeding and major extracranial bleeding) could be identified for all patients managed with a MSU compared to conventional care. We suggest MSU management to improve prehospital management of suspected stroke patients.

最近在不同的临床研究中研究了移动卒中单元 (MSU) 在院前卒中管理中的安全性和疗效。MSU是配备 CT 扫描仪、床旁实验室、远程医疗的救护车，配备了卒中专业医疗团队。本欧洲卒中组织 (ESO) 指南提供了最新的循证建议，以帮助决策者选择使用 MSU 院前管理疑似卒中，包括急性缺血性卒中 (AIS)、颅内出血 (ICH) 和卒中模拟患者。该指南是根据 ESO 标准操作规程和建议、评估、开发和评价分级 (GRADE) 方法制定的。工作组确定了相关的临床问题，对文献进行了系统综述和汇总数据荟萃分析，评估了现有证据的质量并提出了具体建议。如果没有足够的证据提供基于 GRADE 方法的建议，则提供专家共识声明。我们发现了中度证据表明 MSU 治疗疑似卒中患者。诊断为 AIS 的患者组显示90天时功能结局改善，发病至治疗时间减少，发病后 60 min 内接受 IVT 的比例增加。MSU管理可能对 ICH 患者有益，因为 MSU 管理与主要转运至三级卒中中心的 ICH 患者比例较高相关。与常规治疗相比，使用 MSU 治疗的所有患者均未发现安全性问题（全因死亡率、IVT治疗的卒中模拟物比例、症状性颅内出血和颅外大出血）。我们建议 MSU 管理来改善疑似卒中患者的院前管理。