International Stroke Conference 2025  /  Imaging Posters I  /  Larger Perfusion Mismatch Volume Is Associated with Longer Hospital Length of Stay in Medium Vessel Occlusion Stroke
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American Heart Association

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Final ID: WP200

Larger Perfusion Mismatch Volume Is Associated with Longer Hospital Length of Stay in Medium Vessel Occlusion Stroke

Abstract Body: Background and purpose
Prolonged length of stay (LOS) following a stroke is associated with unfavorable clinical outcomes. Factors predicting LOS in medium vessel occlusion (MeVO), impacting up to 40% of acute ischemic stroke (AIS) cases, remain underexplored. This study aims to investigate the predictors of LOS in AIS-MeVO.
Methods
We conducted a retrospective analysis of prospectively maintained stroke databases, comprising of AIS cases with MeVO in the anterior circulation, assessed by adequate CT perfusion (CTP). Baseline and clinical data were obtained from electronic health records. Alberta Stroke Program Early CT Scores (ASPECTS) were calculated from noncontrast head CT. The perfusion mismatch volume (Tmax > 6s minus rCBF <30%) volume was reported from CTP. Multiple regression was employed to examine the relationship between baseline parameters and hospital LOS.
Results
A total of 133 patients (median age 71 [IQR 63-80] years, 59.4% females) were included in the study cohort). The perfusion mismatch volume significantly positively correlated with LOS (r=0.264, p=0.004). After adjusting for age, sex, hypertension, diabetes, prior stroke or TIA, admission NIHSS, ASPECTS, Tan score, intravenous thrombolysis, mechanical thrombectomy, and hemorrhagic transformation, a larger mismatch volume remained independently associated with longer hospital stays (β=0.209, 95%CI 0.006-0.412, p=0.045). Additional significant determinants of longer hospital stay included admission NIHSS (β=0.250, 95%CI 0.060-0.440, p=0.010) and mechanical thrombectomy (MT) (β=0.208, 95%CI 0.006-0.410, p=0.044). Among patients who underwent MT (N=83), multiple regression analysis incorporating both perfusion mismatch volume and admission NIHSS revealed that perfusion mismatch volume remained independently associated with LOS (β=0.248, 95%CI 0.019-0.471, p=0.033), while admission NIHSS did not retain significance (β=0.208, 95%CI -0.019-0.433, p=0.071).
Conclusions
In our cohort of AIS patients with MeVO in the anterior circulation, and particularly in those who underwent MT, the perfusion mismatch volume serves as an independent predictor of LOS. These findings offer critical valuable insights in clinical assessments and decision-making protocols of MT in AIS-MeVO.
  • Mei, Janet  ( Johns Hopkins University , Baltimore , Maryland , United States )
  • Hyson, Nathan  ( Johns Hopkins University , Baltimore , Maryland , United States )
  • Dmytriw, Adam  ( Massachusetts General Hospital , Boston , Massachusetts , United States )
  • Wolman, Dylan  ( Brown University , Providence , Rhode Island , United States )
  • Pulli, Benjamin  ( Stanford University , Palo Alto , California , United States )
  • Xu, Risheng  ( Johns Hopkins University , Baltimore , Maryland , United States )
  • Heit, Jeremy  ( Stanford University , Palo Alto , California , United States )
  • Faizy, Tobias  ( University of Munster , Munster , Germany )
  • Soman, Salil  ( Beth Israel Deaconess Medical Center , Boston , Massachusetts , United States )
  • Albers, Greg  ( Stanford University , Stanford , California , United States )
  • Urrutia, Victor  ( Johns Hopkins University , Baltimore , Maryland , United States )
  • Lakhani, Dhairya  ( Johns Hopkins University , Baltimore , Maryland , United States )
  • Marsh, Elisabeth  ( Johns Hopkins School of Medicine , Baltimore , Maryland , United States )
  • Nael, Kambiz  ( UCLA , Los Angeles , California , United States )
  • Aziz, Yasmin  ( University of Cincinnati , Cincinnati , Ohio , United States )
  • Sriwastwa, Aakanksha  ( University of Cincinnati , Cincinnati , Ohio , United States )
  • Yedavalli, Vivek  ( Johns Hopkins School of Medicine , Baltimore , Maryland , United States )
  • Alizada, Sahar  ( Istanbul University-Cerrahpasa , Istanbul , Turkey )
  • Vagal, Vaibhav  ( Renaissance School of Medicine at Stony Brook University , Stony Brook , New York , United States )
  • Koneru, Manisha  ( Cooper Medical School of Rowan Univ , Camden , New Jersey , United States )
  • Salim, Hamza  ( Johns Hopkins University , Baltimore , Maryland , United States )
  • Balar, Aneri  ( Johns Hopkins University , Baltimore , Maryland , United States )
  • Luna, Licia  ( Johns Hopkins University , Baltimore , Maryland , United States )
  • Deng, Francis  ( Johns Hopkins University , Baltimore , Maryland , United States )
    • Author Disclosures:
    Janet Mei: DO NOT have relevant financial relationships | Nathan Hyson: DO NOT have relevant financial relationships | Adam Dmytriw: DO NOT have relevant financial relationships | Dylan Wolman: DO have relevant financial relationships ; Consultant:J&J MedTech:Active (exists now) | Benjamin Pulli: DO NOT have relevant financial relationships | Risheng Xu: DO NOT have relevant financial relationships | Jeremy Heit: DO have relevant financial relationships ; Consultant:Medtronic:Active (exists now) ; Ownership Interest:Dragon Medical:Active (exists now) ; Research Funding (PI or named investigator):NIH:Active (exists now) ; Consultant:Balt:Active (exists now) ; Consultant:MicroVention:Active (exists now) | Tobias Faizy: No Answer | Salil Soman: No Answer | Greg Albers: DO have relevant financial relationships ; Consultant:iSchemaView:Active (exists now) ; Consultant:Genentech:Past (completed) ; Ownership Interest:iSchemaView:Active (exists now) | Victor Urrutia: DO have relevant financial relationships ; Research Funding (PI or named investigator):Genentech:Active (exists now) | Dhairya Lakhani: DO NOT have relevant financial relationships | Elisabeth Marsh: DO NOT have relevant financial relationships | Kambiz Nael: DO have relevant financial relationships ; Consultant:Olea Medical:Active (exists now) ; Consultant:Brainomix:Active (exists now) | Yasmin Aziz: DO NOT have relevant financial relationships | Aakanksha Sriwastwa: No Answer | Vivek Yedavalli: DO have relevant financial relationships ; Consultant:RAPIDAI Ischemaview (Menlo Park, CA, USA):Active (exists now) | Sahar Alizada: DO NOT have relevant financial relationships | Vaibhav Vagal: DO NOT have relevant financial relationships | Manisha Koneru: DO NOT have relevant financial relationships | Hamza Salim: No Answer | Aneri Balar: No Answer | Licia Luna: DO NOT have relevant financial relationships | Francis Deng: No Answer
Meeting Info:

International Stroke Conference 2025

2025

Los Angeles, CA

Session Info:

Imaging Posters I

Wednesday, 02/05/2025 , 07:00PM - 07:30PM

Poster Abstract Session

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