Introduction Early mechanical thrombectomy (MT) improves functional outcomes for patients with acute LVO. It has been shown that earlier MT resulted in reduced hospital stay and improved living situation at 90 days after stroke.
Aim of Study We hypothesized that delay in MT in patients with LVO would result in worse clinical outcome and increased mortality.
Methods We performed a retrospective analysis of patients who underwent MT for LVO in a comprehensive stroke center (2018 – 2021.) We compared outcomes including in-hospital mortality and 90-day mRS based on time from door-to-puncture and door-to-reperfusion, adjusting for covariates using logistic regression
Results very 10-minute delay to reperfusion decreased the probability of mRS 0–2 at 90 days (OR 0.99, 95%CI 0.98 – 0.99, p=0.002), increased the probability of inpatient mortality (OR 1.01, 95%CI 1.00 – 1.01, p=0.01), and increased probability of 90-day mortality (OR 1.01, 95%CI 1.00 – 1.01, p=0.005.) Adjusting for baseline characteristics (p=0.01), PMH (p=0.01), admission labs and vital signs (p=0.002), initial stroke assessment and management (p=0.001), delayed times to reperfusion worsened 90-day mRS. After adjusting for the same groups of variables, delayed times to puncture and reperfusion also increased significantly (p<0.05) the probability of mortality while inpatient and at 90 days.
Conclusion Shorter times to puncture and reperfusion impact mRS and mortality in LVO stroke patients. Adequate hospital protocols and education may lead to faster and more efficient stroke activations leading to a shorter time to MT and reperfusion. Goals of door-to-puncture must be established in order to achieve better outcome.
Disclosure of Interest Nothing to disclose
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