RT Journal Article
SR Electronic
T1 Obstructive sleep apnea confers lower mortality risk in acute ischemic stroke patients treated with endovascular thrombectomy: National Inpatient Sample analysis 2010–2018
JF Journal of NeuroInterventional Surgery
JO J NeuroIntervent Surg
FD BMJ Publishing Group Ltd.
SP 1195
OP 1199
DO 10.1136/neurintsurg-2021-018161
VO 14
IS 12
A1 Justin M Lapow
A1 Alis J Dicpinigaitis
A1 Rajkumar S Pammal
A1 Griffin A Coghill
A1 Osher Rechester
A1 Eric Feldstein
A1 Rolla Nuoman
A1 Kristina Maselli
A1 Shyla Kodi
A1 Andrew Bauerschmidt
A1 Jon B Rosenberg
A1 Shadi Yaghi
A1 Gurmeen Kaur
A1 Christeen Kurian
A1 Ji Y Chong
A1 Stephan A Mayer
A1 Chirag D Gandhi
A1 Fawaz Al-Mufti
YR 2022
UL http://jnis.bmj.com/content/14/12/1195.abstract
AB Obstructive sleep apnea (OSA) portends increased morbidity and mortality following acute ischemic stroke (AIS). Evaluation of OSA in the setting of AIS treated with endovascular mechanical thrombectomy (MT) has not yet been evaluated in the literature.Methods The National Inpatient Sample from 2010 to 2018 was utilized to identify adult AIS patients treated with MT. Those with and without OSA were compared for clinical characteristics, complications, and discharge disposition. Multivariable logistic regression analysis and propensity score adjustment (PA) were employed to evaluate independent associations between OSA and clinical outcome.Results Among 101 093 AIS patients treated with MT, 6412 (6%) had OSA. Those without OSA were older (68.5 vs 65.6 years old, p<0.001), female (50.5% vs 33.5%, p<0.001), and non-caucasian (29.7% vs 23.7%, p<0.001). The OSA group had significantly higher rates of obesity (41.4% vs 10.5%, p<0.001), atrial fibrillation (47.1% vs 42.2%, p=0.001), hypertension (87.4% vs 78.5%, p<0.001), and diabetes mellitus (41.2% vs 26.9%, p<0.001). OSA patients treated with MT demonstrated lower rates of intracranial hemorrhage (19.1% vs 21.8%, p=0.017), treatment of hydrocephalus (0.3% vs 1.1%, p=0.009), and in-hospital mortality (9.7% vs 13.5%, p<0.001). OSA was independently associated with lower rate of in-hospital mortality (aOR 0.76, 95% CI 0.69 to 0.83; p<0.001), intracranial hemorrhage (aOR 0.88, 95% CI 0.83 to 0.95; p<0.001), and hydrocephalus (aOR 0.51, 95% CI 0.37 to 0.71; p<0.001). Results were confirmed by PA.Conclusions Our findings suggest that MT is a viable and safe treatment option for AIS patients with OSA.Data are available in a public, open access repository. N/A.