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Ischemic stroke
Original research
Evaluating outcome associations with race after mechanical thrombectomy: an analysis of the NVQI-QOD acute ischemic stroke registry
  1. Angelica Fuentes1,
  2. Vineeth Thirunavu2,
  3. Syed Hasib Akhter Faruqui2,
  4. Chaochao Zhou2,
  5. Laura Stone McGuire3,
  6. Xinjian Du3,
  7. Dilip Pandey4,
  8. Donald Cantrell2,
  9. Sameer A Ansari5,
  10. Sepideh Amin-Hanjani3,6
  1. 1Department of Neurosurgery, University of Virginia, Charlottesville, Virginia, USA
  2. 2Department of Radiology, Neurology, and Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
  3. 3Department of Neurosurgery, University of Illinois at Chicago, Chicago, Illinois, USA
  4. 4Department of Neurology, University of Illinois at Chicago, Chicago, Illinois, USA
  5. 5Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
  6. 6Department of Neurosurgery, University Hospitals Cleveland Medical Center/ Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
  1. Correspondence to Dr Sepideh Amin-Hanjani, Department of Neurosurgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA; sepideh.hanjani{at}uhhospitals.org

Abstract

Background Mechanical thrombectomy has become the standard of care for acute ischemic stroke due to large vessel occlusions. Racial differences in outcomes after mechanical thrombectomy for acute ischemic stroke have not been extensively studied. We evaluate the real-world evidence for differences between races in the outcomes of thrombectomy for large vessel occlusions using the NeuroVascular Quality Initiative-Quality Outcomes Database (NVQI-QOD).

Methods Data from the NVQI-QOD acute ischemic stroke registry were analyzed and compared for racial differences in outcomes after mechanical thrombectomy in 4507 patients from 28 US centers (17 states) between January 2014 and April 2021. Race was dichotomized into non-Hispanic White (NHW, n=3649) and non-Hispanic Black (NHB, n=858). We performed 1:1 propensity score matching resulting in a subsample of matched groups (n=761 each for NHB and NHW) to compare study endpoints using Welch’s two-sided t-tests and Χ2 test for continuous and categorical outcomes, respectively.

Results Prior to matching, NHW and NHB patients significantly differed in age, comorbidities, medication use, smoking status, and presenting stroke severity. No significant difference in functional outcomes or mortality, at discharge or follow-up, were revealed. NHB patients had higher average postprocedure length of stay than NHW patients, which persisted following matching (11.2 vs 9.1 days, P=0.004).

Conclusion Evidence from the NVQI-QOD acute ischemic stroke registry showed that outcome metrics, such as modified Rankin Scale score and mortality, did not differ significantly between racial groups; however, disparity between NHW and NHB patients in postprocedure length of stay following mechanical thrombectomy was revealed.

  • Stroke
  • Thrombectomy

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

https://doi.org/10.1136/jnis-2023-021208

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    Data availability statement

    All data relevant to the study are included in the article or uploaded as supplementary information.

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    Footnotes

    • Twitter @stonemcguire

    • Contributors AF was involved in study planning, idea formation, writing draft and final copy of manuscript, data analysis, and approval of final version of manuscript. VT helped with study planning, writing drafts and the final copy of manuscript, data acquisition, data analysis, and approval of final version of manuscript. SHAF assisted with data acquisition, data analysis, and approval of final version of manuscript. CZ was involved with data acquisition, data analysis, and approval of final version of manuscript. LSM assisted with writing drafts and final copy of the manuscript, critical editing of manuscript, and approval of final version of manuscript. XD helped with data analysis, critical editing of manuscript, and approval of final version of manuscript. DP was involved with data analysis, critical editing of manuscript, and approval of final version of manuscript. DC helped write the final copy of manuscript, and assisted with critical editing of manuscript and approval of final version of manuscript. SAA was involved with study planning, idea formation, writing draft and final copy of manuscript, data analysis, critical editing of manuscript, and approval of final version of manuscript. SA-H assisted with study planning, idea formation, critical editing of manuscript, and approval of final version of manuscript. She is the guarantor.

    • 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.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.