Patient outcomes with endovascular embolectomy therapy for acute ischemic stroke: A study of the national inpatient sample: 2006 to 2008

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Abstract

Background And Purpose- Maturing techniques have spurred widespread implementation of endovascular embolectomy therapy for ischemic stroke. We evaluated a large administrative database to determine outcomes in patients treated with endovascular embolectomy in the general population. Methods- Using the National Inpatient Sample, we evaluated outcomes of patients treated for acute ischemic stroke in the United States from 2006 to 2008. Patients who had an ischemic stroke and underwent endovascular clot retrieval were identified. Morbidity, defined as "discharge to long-term facility," and mortality were evaluated as a function of patient age and of concomitant thrombolytic agent administration. Results- For 2006 to 2008, a total of 3864 patients received endovascular clot retrieval with 266 (6.9%) patients in 2006, 800 (20.7) patients in 2007, and 2798 (72.4%) patients in 2008. The discharge to a long-term facility rate was 51.3% (1983 of 3864). The in-hospital mortality rate was 24.3% (940 of 3864). For patients <65 years old, the rate of in-hospital death was 17.1% (283 of 1658) as compared with a rate of 29.7% (656 of 2206) for patients 65 years old (P<0.0001). The rate of discharge to a long-term facility was 47.6% (789 of 1658) for patients <65 years old and 54.1% (1193 of 2206) for patients 65 years old (P<0.0001). The rate of intracranial hemorrhage was 15.5% without concomitant thrombolysis and 20.0% with concomitant thrombolysis (P=0.0009). Conclusions- Rates of morbidity and mortality remain high for patients with acute stroke, even in the setting of endovascular embolectomy. Advanced age portends a worse outcome and patients treated with concomitant use of thrombolytic agent had higher rates of intracranial hemorrhage than those without such therapy.

Original languageEnglish (US)
Pages (from-to)1648-1652
Number of pages5
JournalStroke
Volume42
Issue number6
DOIs
StatePublished - Jun 2011

Fingerprint

Embolectomy
Inpatients
Stroke
Therapeutics
Fibrinolytic Agents
Intracranial Hemorrhages
Mortality
Morbidity
Hospital Mortality

Keywords

  • acute stroke
  • endovascular treatment
  • interventional neuroradiology
  • outcomes
  • thrombolysis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Clinical Neurology
  • Advanced and Specialized Nursing

Cite this

@article{a02031518887497b9611bda93bb78ce8,
title = "Patient outcomes with endovascular embolectomy therapy for acute ischemic stroke: A study of the national inpatient sample: 2006 to 2008",
abstract = "Background And Purpose- Maturing techniques have spurred widespread implementation of endovascular embolectomy therapy for ischemic stroke. We evaluated a large administrative database to determine outcomes in patients treated with endovascular embolectomy in the general population. Methods- Using the National Inpatient Sample, we evaluated outcomes of patients treated for acute ischemic stroke in the United States from 2006 to 2008. Patients who had an ischemic stroke and underwent endovascular clot retrieval were identified. Morbidity, defined as {"}discharge to long-term facility,{"} and mortality were evaluated as a function of patient age and of concomitant thrombolytic agent administration. Results- For 2006 to 2008, a total of 3864 patients received endovascular clot retrieval with 266 (6.9{\%}) patients in 2006, 800 (20.7) patients in 2007, and 2798 (72.4{\%}) patients in 2008. The discharge to a long-term facility rate was 51.3{\%} (1983 of 3864). The in-hospital mortality rate was 24.3{\%} (940 of 3864). For patients <65 years old, the rate of in-hospital death was 17.1{\%} (283 of 1658) as compared with a rate of 29.7{\%} (656 of 2206) for patients 65 years old (P<0.0001). The rate of discharge to a long-term facility was 47.6{\%} (789 of 1658) for patients <65 years old and 54.1{\%} (1193 of 2206) for patients 65 years old (P<0.0001). The rate of intracranial hemorrhage was 15.5{\%} without concomitant thrombolysis and 20.0{\%} with concomitant thrombolysis (P=0.0009). Conclusions- Rates of morbidity and mortality remain high for patients with acute stroke, even in the setting of endovascular embolectomy. Advanced age portends a worse outcome and patients treated with concomitant use of thrombolytic agent had higher rates of intracranial hemorrhage than those without such therapy.",
keywords = "acute stroke, endovascular treatment, interventional neuroradiology, outcomes, thrombolysis",
author = "Waleed Brinjikji and Alejandro Rabinstein and Kallmes, {David F} and Cloft, {Harry J.}",
year = "2011",
month = "6",
doi = "10.1161/STROKEAHA.110.607952",
language = "English (US)",
volume = "42",
pages = "1648--1652",
journal = "Stroke",
issn = "0039-2499",
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T1 - Patient outcomes with endovascular embolectomy therapy for acute ischemic stroke

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AU - Brinjikji, Waleed

AU - Rabinstein, Alejandro

AU - Kallmes, David F

AU - Cloft, Harry J.

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N2 - Background And Purpose- Maturing techniques have spurred widespread implementation of endovascular embolectomy therapy for ischemic stroke. We evaluated a large administrative database to determine outcomes in patients treated with endovascular embolectomy in the general population. Methods- Using the National Inpatient Sample, we evaluated outcomes of patients treated for acute ischemic stroke in the United States from 2006 to 2008. Patients who had an ischemic stroke and underwent endovascular clot retrieval were identified. Morbidity, defined as "discharge to long-term facility," and mortality were evaluated as a function of patient age and of concomitant thrombolytic agent administration. Results- For 2006 to 2008, a total of 3864 patients received endovascular clot retrieval with 266 (6.9%) patients in 2006, 800 (20.7) patients in 2007, and 2798 (72.4%) patients in 2008. The discharge to a long-term facility rate was 51.3% (1983 of 3864). The in-hospital mortality rate was 24.3% (940 of 3864). For patients <65 years old, the rate of in-hospital death was 17.1% (283 of 1658) as compared with a rate of 29.7% (656 of 2206) for patients 65 years old (P<0.0001). The rate of discharge to a long-term facility was 47.6% (789 of 1658) for patients <65 years old and 54.1% (1193 of 2206) for patients 65 years old (P<0.0001). The rate of intracranial hemorrhage was 15.5% without concomitant thrombolysis and 20.0% with concomitant thrombolysis (P=0.0009). Conclusions- Rates of morbidity and mortality remain high for patients with acute stroke, even in the setting of endovascular embolectomy. Advanced age portends a worse outcome and patients treated with concomitant use of thrombolytic agent had higher rates of intracranial hemorrhage than those without such therapy.

AB - Background And Purpose- Maturing techniques have spurred widespread implementation of endovascular embolectomy therapy for ischemic stroke. We evaluated a large administrative database to determine outcomes in patients treated with endovascular embolectomy in the general population. Methods- Using the National Inpatient Sample, we evaluated outcomes of patients treated for acute ischemic stroke in the United States from 2006 to 2008. Patients who had an ischemic stroke and underwent endovascular clot retrieval were identified. Morbidity, defined as "discharge to long-term facility," and mortality were evaluated as a function of patient age and of concomitant thrombolytic agent administration. Results- For 2006 to 2008, a total of 3864 patients received endovascular clot retrieval with 266 (6.9%) patients in 2006, 800 (20.7) patients in 2007, and 2798 (72.4%) patients in 2008. The discharge to a long-term facility rate was 51.3% (1983 of 3864). The in-hospital mortality rate was 24.3% (940 of 3864). For patients <65 years old, the rate of in-hospital death was 17.1% (283 of 1658) as compared with a rate of 29.7% (656 of 2206) for patients 65 years old (P<0.0001). The rate of discharge to a long-term facility was 47.6% (789 of 1658) for patients <65 years old and 54.1% (1193 of 2206) for patients 65 years old (P<0.0001). The rate of intracranial hemorrhage was 15.5% without concomitant thrombolysis and 20.0% with concomitant thrombolysis (P=0.0009). Conclusions- Rates of morbidity and mortality remain high for patients with acute stroke, even in the setting of endovascular embolectomy. Advanced age portends a worse outcome and patients treated with concomitant use of thrombolytic agent had higher rates of intracranial hemorrhage than those without such therapy.

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KW - endovascular treatment

KW - interventional neuroradiology

KW - outcomes

KW - thrombolysis

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