Abstract Details

Title Endovascular Thrombectomy for Stroke in Patients with Low NIHSS Scores and Outside the Thrombolysis Window: A Nationwide Inpatient Sample Analysis 2016-2019

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P1 - Poster Session 1 (8:00 AM-9:00 AM)

Poster/Presentation
Number 5-016

Objective

To assess safety and short-term functional outcomes of Endovascular Thrombectomy (EVT) in patients with minor acute strokes with NIHSS ≤ 6 without thrombolysis (tTA)

Background Uncertainty persists surrounding the therapeutic benefit of EVT without thrombolytics, in treatment of patients with minor acute ischemic strokes (NIHSS <6). There is a proven benefit of EVT in moderate to severe strokes in large randomized clinical trials, but there is limited evidence in literature on the effect of EVT in low NIHSS group

Design/Methods We used the Nationwide Inpatient Sample (NIS) database from 2016 to 2019 to identify patients with Acute Ischemic Stroke. We selected patients with NIHSS ≤ 6, who did not receive thrombolysis. We compared outcomes of patients who received endovascular thrombectomy to those who did not, including inpatient mortality, length of stay, and discharge disposition (home vs. rehabilitation facility) as dependent variables. We used chi-squared tests for categorical variables and t-tests for continuous variables in univariate analysis. We used logistic and linear regression in multivariate analysis to adjust for comorbidities (hypertension, diabetes mellitus, obesity, and smoking)

Results A total of 426,145 patients were extracted with given selection criteria. Mean age of 66 vs 68 (p<0.001) in EVT vs no EVT group. Overall, EVT group is associated with increased in hospital mortality (OR 8.693, CI 7.63-9.90, p <0.001), increased risk of discharging to Rehab facility (RR 1.42 CI 1.33-1.51, p<0.001) and increased length of stay in the hospital 5.73 vs 3.76 (β=1.9, p <0.001)

Conclusions Our study found that patients with low of NIHSS ≤ 6 who received endovascular thrombectomy (EVT) without thrombolytics had worse outcomes, including higher in-hospital mortality, more frequent discharge to rehabilitation facilities, and longer hospital stays

Authors/Disclosures
Prabandh R. Buchhanolla, MBBS PRESENTER	Dr. Buchhanolla has nothing to disclose.
Mohammad A. Sheikh, MBBS (LSU Health Shreveport)	Dr. Sheikh has nothing to disclose.
Muhammad Ayub, MD (Louisiana State University, Shreveport)	Dr. Ayub has nothing to disclose.
Omar Elsekaily, MBBS (LSU shreveport)	Dr. Elsekaily has nothing to disclose.
Monika Thapa, MBBS (Department of Neurology)	Dr. Thapa has nothing to disclose.
Jordyn Courville	No disclosure on file
Lakshmi Chandaluri (LSUHS)	No disclosure on file
Saurabh Kataria, MD (Pier Landing)	Dr. Kataria has nothing to disclose.
Rahul Shah, MBBS (LSU Shreveport)	Dr. Shah has nothing to disclose.
Himanshu Chokhawala, MD (LSUHSC - SHreveport)	Dr. Chokhawala has nothing to disclose.

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