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Original research
Rates of adverse events in patients with ischemic stroke treated at thrombectomy capable hospitals
  1. Saqib A Chaudhry1,
  2. Humaira Sadaf2,
  3. Ibrahim Laleka2,
  4. Wahid Nasir1,3,
  5. Catherine Witzel4,
  6. Zelalem Bahiru2,
  7. Yun Fang2,
  8. Fawad Ishfaq5,
  9. Laith R Altaweel2,
  10. Adnan Qureshi6
  1. 1Neuroscience Intensive Care Unit, Inova Fairfax Medical Campus, Falls Church, Virginia, USA
  2. 2Department of Neuroscience, Neuroscience and Spine Institute, INOVA Fairfax Medical Campus, Fairfax, Virginia, USA
  3. 3Department of Medicine, INOVA Fairfax Medical Campus, Fairfax, Virginia, USA
  4. 4Department of Neurology, University of Minnesota, Minneapolis, Minnesota, USA
  5. 5Department of Neurology, University of Tennessee Health Science Center, Memphis, Tennessee, USA
  6. 6Department of Neurology, University Hospital, Columbia, Missouri, USA
  1. Correspondence to Dr Saqib A Chaudhry, Neuroscience Intensive Care Unit, Inova Fairfax Medical Campus, Falls Church, Virginia, USA; chaudhrys208{at}gmail.com

Abstract

Objective To identify the beneficial effects of thrombectomy capable hospitals (TCHs), by comparing the incidence of in-hospital adverse events and discharge outcomes among patients with ischemic stroke treated at thrombectomy capable and non-thrombectomy capable hospitals in the United States.

Methods We used the data from the Nationwide Inpatient Sample from January 2012 to December 2017. Thrombectomy capable hospitals were identified based on the number of thrombectomy procedures performed by a hospital each year among patients with ischemic stroke. If a hospital performed 10 or more thrombectomy procedures, it was labelled a TCH. The inclusion criteria were age ≥18 years, and ischemic stroke (International Classification of Diseases 433 .x1-434.x1 (ICD-9) or I63 (ICD-10)) as primary discharge diagnosis. A comparative analysis of propensity-matched patient groups was done to study the influence of TCH admissions on in-hospital outcomes.

Results A total of 2 826 334 patients with primary ischemic stroke were identified. In a multivariate logistic regression model after adjusting for age, sex, race/ethnicity, hospital teaching status, comorbidities, and all patients refined diagnosis-related groups-based disease severity, patients admitted to a TCH were found to have low incidence of in-hospital adverse events: pneumonia (OR=0.86, 95% CI 0.78 to 0.93), urinary tract infection (OR=0.87, 95% CI 0.84 to 0.91), sepsis (OR=0.91, 95% CI 0.81 to 1.02), and pulmonary embolism (OR=0.89, 95% CI 0.77 to 1.03); in-hospital death (OR=0.82, 95% CI 0.78 to 0.88); and higher rate of home discharge (OR=1.09, 95% CI 1.06 to 1.12).

Conclusions A decrease in-hospital adverse events and improved discharge outcomes were observed among patients with ischemic stroke admitted to a TCH compared with a non-TCH.

  • stroke
  • thrombectomy

Data availability statement

Data are available in a public, open access repository. N/A.

Statistics from Altmetric.com

Data availability statement

Data are available in a public, open access repository. N/A.

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Footnotes

  • Contributors All authors have contributed equally

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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