International Stroke Conference 2025  /  Cerebrovascular Systems of Care Moderated Poster Tour I  /  High Mechanical Thrombectomy Procedural Volume is Not a Reliable Predictor of Improved Thrombectomy Outcomes in Patients with Acute Ischemic Stroke in the United States

American Heart Association

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Final ID: WMP28

High Mechanical Thrombectomy Procedural Volume is Not a Reliable Predictor of Improved Thrombectomy Outcomes in Patients with Acute Ischemic Stroke in the United States

Abstract Body: Abstract
Background: The volume of mechanical thrombectomy (MT) performed at hospitals is used as one of the criteria for advanced level designation for stroke care.
Objective: Our study sought to determine the relationship between annual MT procedural volume and in-hospital outcomes in acute ischemic stroke patients undergoing MT in the United States.
Methods: We analysed from the National Inpatient Sample from 2016 to 2020. The hospitals were groups into quartiles based on the volume of MT procedures performed within the calendar year. We compared the rates of routine discharge/home health care; in-hospital mortality, and post-treatment intracranial haemorrhage (ICH) between the quartiles after adjusting for potential confounders.
Results: Patients undergoing MT ranged from 15,395 in quartile 1 to 78,510 MT in quartile 4. There were lower rates of discharge home/self-care of 22.5%, 20.8% and 20.8% for quartiles 2, 3 and 4, respectively compared with 34.9% in the quartile 1. The odds of ICH increased to 1.81 (p<0.001), 1.84 (p<0.001), and 1.98 (p<0.001) among the quartiles from lowest to highest procedural volumes. The odds of home discharge/self-care decreased to 0.66 (p<0.001), 0.60 (p<0.001), and 0.63 (p<0.001) among the quartiles from lowest to highest procedural volumes. The odds of in-hospital mortality increased to 1.92 (p<0.001), 1.99 (p<0.001), and 1.84 (p<0.001) among the quartiles from lowest to highest procedural volumes.
Conclusions: We observed a paradoxical relationship between adverse outcomes and annual procedural volume of MT at the hospital presumably due to higher severity of acute ischemic stroke treated at high volume hospitals.
  • Qureshi, Adnan  ( University of Missouri , Columbia , Missouri , United States )
  • Spiotta, Alejandro  ( MUSC , Charleston , South Carolina , United States )
  • Zaidi, Syed  ( University of Toledo , Toledo , Ohio , United States )
  • Kwok, Chun Shing  ( University Hospitals of North Midlands NHS Trust , Stoke-on-Trent , United Kingdom )
  • Maqsood, Hamza  ( University of Missouri Columbia , Columbia , Missouri , United States )
  • Bhatti, Ibrahim  ( University of Missouri Columbia , Columbia , Missouri , United States )
  • Ford, Daniel  ( John Hopkins University , Baltimore , Maryland , United States )
  • Gomez, Camilo  ( University of Missouri Columbia , Columbia , Missouri , United States )
  • Hanley, Daniel  ( John Hopkins University , Baltimore , Maryland , United States )
  • Hassan, Ameer  ( UTRGV - VALLEY BAPTIST MEDICAL CENT , Harlingen , Texas , United States )
  • Nguyen, Thanh  ( Boston University School of Medicine , Boston , Massachusetts , United States )
  • Siddiq, Farhan  ( University of Missouri Columbia , Columbia , Missouri , United States )
    • Author Disclosures:
    Adnan Qureshi: DO have relevant financial relationships ; Ownership Interest:Qureshi Medical LLC:Active (exists now) ; Ownership Interest:QuReVasc LLC:Active (exists now) ; Ownership Interest:DyQure LLC:Active (exists now) | Alejandro Spiotta: DO have relevant financial relationships ; Consultant:Penumbra:Past (completed) ; Research Funding (PI or named investigator):RapidAI:Past (completed) ; Research Funding (PI or named investigator):Medtronic:Active (exists now) ; Research Funding (PI or named investigator):Stryker:Active (exists now) ; Research Funding (PI or named investigator):Microvention:Active (exists now) ; Research Funding (PI or named investigator):Penumbra:Active (exists now) ; Consultant:Terumo:Active (exists now) ; Consultant:RapidAI:Past (completed) | Syed Zaidi: No Answer | Chun Shing Kwok: No Answer | Hamza Maqsood: DO NOT have relevant financial relationships | Ibrahim Bhatti: DO NOT have relevant financial relationships | Daniel Ford: DO NOT have relevant financial relationships | Camilo Gomez: DO NOT have relevant financial relationships | Daniel Hanley: DO have relevant financial relationships ; Consultant:HiCatlyst:Active (exists now) ; Research Funding (PI or named investigator):U.S. Department of Defense W911QY2090012:Active (exists now) ; Research Funding (PI or named investigator):NIH/NCATS U24TR001609:Past (completed) ; Research Funding (PI or named investigator):NIH/NCATS U24TR004440:Active (exists now) ; Ownership Interest:EpiWatch:Active (exists now) | Ameer Hassan: DO have relevant financial relationships ; Consultant:Medtronic, Microvention, Stryker, Penumbra, Cerenovus, Genentech, GE Healthcare, Scientia, Balt, Viz.ai , Insera therapeutics, Proximie, NeuroVasc, NovaSignal, Vesalio, Rapid Medical, Imperative Care, Galaxy Therapeutics, Route 92, Perfuze, CorTech, Shockwave and Xcath:Active (exists now) | Thanh Nguyen: DO have relevant financial relationships ; Other (please indicate in the box next to the company name):American Stroke Association:Active (exists now) ; Advisor:Aruna Bio:Past (completed) ; Advisor:Brainomix:Active (exists now) | Farhan Siddiq: No Answer
Meeting Info:

International Stroke Conference 2025

2025

Los Angeles, CA

Session Info:

Cerebrovascular Systems of Care Moderated Poster Tour I

Wednesday, 02/05/2025 , 06:00PM - 07:00PM

Moderated Poster Abstract Session

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