Early assessment by a mobile stroke team: a randomised controlled trial

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Abstract
Background: there is overwhelming evidence of the effectiveness of specialist stroke rehabilitation, but more limited evidence of the effectiveness of organised stroke care during the acute phase of stroke. Objective: to determine the impact on outcome of access to a mobile team during the acute phase of stroke among patients admitted to general wards. Study population: 308 patients admitted to one of two hospitals within 5 days of the onset of a clinically diagnosed stroke. Study design: randomised controlled trial. Study groups: following admission, patients in the intervention arm were visited by members of a mobile stroke team who advised clinical staff on appropriate and timely investigation and management. They co-ordinated early input from therapy groups and identified those ready for transfer to the stroke rehabilitation unit. Patients in the control arm were not visited by the mobile stroke team. Main outcome measure: all-cause mortality measured at 6 weeks and 12 months. Results: there was no statistically significant difference observed between study groups in mortality at 6 weeks (95% CIadj –7.4 to 7.4%) nor at 12 months ( 95% CIadj –4.1 to 15.9%). There were also no differences observed between study groups in morbidity outcomes or health-related quality of life measured at 12 months. Conclusion: the trial was terminated before the necessary sample size was collected but findings suggest that the mobile stroke team failed to confer significant long-term mortality benefit compared with general ward-based care alone.