Heinrich Audebert (Germany)
Charité - Universitätsmedizin Berlin
Department of Neurology
Prof Heinrich Audebert is neurologist with a research focus on clinical stroke health care. He is head of the Dept. of Neurology at Charité Campus Benjamin Franklin in Berlin/Germany. He initiated and coordinated several TeleStroke networks in Germany and the UK. Since his assignment at Charité Berlin in 2008, he has set up several major health programs in stroke care including prehospital and inpatient stroke management as well as secondary prevention. His research group developed a new support program for patients after minor stroke or TIA that was evaluated in a large international multicenter randomized trial (INSPiRE-TMS). The support program led to better quality of secondary prevention according to prevention targets but was not associated with a significant reduction of major vascular events. Prof Audebert initiated the Stroke-Emergency Mobile (STEMO) or Mobile Stroke Unit project exploring the effects of a specialized ambulance for hyperacute stroke care with integrated CT-scanner and point-of care laboratory. Controlled studies have shown, that prehospital acute stroke treatment is safe, increases the thrombolysis rate and shortens time to treatment. The prospective controlled B_PROUD study showed improved outcome in acute ischemic stroke patients after dispatch of a Mobile stroke Unit.

Moderator of 1 Session

 Conference Calendar

Advancing Health Care Policy for Stroke

Session Type
Main Theme Symposium
Date
28.10.2021, Thursday
Session Time
15:45 - 17:15
Room
MAIN THEME A
Chair(s)
Session Icon
Live Session

Presenter of 1 Presentation

 Conference Calendar

PRESTO Consortium: Insights From New Mobile Stroke Unit Studies And Ongoing Research

Session Name
0520 - Prehospital Stroke Care (ID 39)
Session Type
Plenary Session
Date
28.10.2021, Thursday
Session Time
19:15 - 20:45
Room
PLENARY
Presenter
Lecture Time
19:29 - 19:43

Abstract

Abstract Body

Time to treatment is the most powerful modifier for effective recanalizing treatments of acute ischemic stroke. Starting stroke workup already pre-hospital on Mobile Stroke Units (MSU) promises earlier treatment and better triage regarding the most appropriate hospital. The PRE-Hospital Stroke Treatment Organization (PRESTO) is a group of MSU initiatives around the world collaborating in research and further development of pre-hospital stroke care.

After the first description of the MSU concept in 2003, feasibility, safety and effects on shortening time to treatment have been shown in various settings. Recently, two large controlled studies in Germany and the US showed improved functional outcome in patients with acute ischemic stroke by pre-hospital management on MSUs with absolute differences in favorable outcome (mRS≤1) of 9 and 10%. Currently, effects on outcome in patients with intracerebral hemorrhage by earlier blood pressure lowering and anticoagulation reversal are being analyzed. The speed of further MSU implementations in different settings will depend on the results of still ongoing cost-effectiveness evaluations. PRESTO has established common data elements for recording in all MSU programs and is working on the definition of performance benchmarks.

There remain open questions that are currently under investigation: How can the MSU services be reimbursed in different health care settings? Which strategies lead to better stroke recognition and more accurate MSU alerts at dispatch level? Will new stroke treatment innovations be particularly effective when administered in the hyperacute time window on MSUs? Will technological advances help to make pre-hospital stroke (subtype) diagnoses available on normal ambulances?

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