Stoke patients who underwent mechanical thrombectomy between 2018-2020 were identified from the National Inpatient Sample (NIS) database using ICD-10 codes I63 (stroke), 03CG3ZZ (Thrombectomy), and Z9282/3E03317 (IV-tPA). Medians and interquartile ranges (IQRs) were calculated for descriptive statistics, and odds ratios (ORs) were used for associations. A p<0.05 was considered statistically significant.

A total of 1,560,970 (97.45%) patients out of 1,601,840 hospital admissions principally diagnosed with stroke, with a median age of 71 (IQR 61–81) years, were included in the study. Males were significantly less likely to undergo thrombectomy than females (OR 0.89, p<0.001). Native Americans (OR 0.64, p=0.031), Blacks (OR 0.78, p<0.001), and Hispanics (OR 0.81, p<0.001) were less likely to undergo mechanical thrombectomy than Whites. However, patients in the East South Central (OR 1.32, p=0.006), Mountain (OR 1.25, p=0.021), Pacific (OR 1.18, p=0.037), and South Atlantic (OR 1.25, p=0.002) regions exhibited higher thrombectomy utilization than those in the East North Central. Patients with the highest residential income (>$88,000) also demonstrated a higher likelihood of receiving thrombectomy (OR 1.15, p=0.001) compared to those with lower incomes (<$52,000).

The disparities in mechanical thrombectomy utilization particularly affect minority groups, males, lower-income individuals, and those treated at non-metropolitan or rural hospitals. These findings emphasize the importance of collecting socio-demographic information for all hospital admissions to improve outcomes for patients undergoing thrombectomy for ischemic strokes.