Abstract TP109: The Impact Of Atrial Fibrillation (Afib) On The Discharge Disposition In Patients Who Received Acute Stroke Intervention Therapies? Results From A Large Health System In Six Western States Of The United States

Abstract

Introduction: Limited studies indicate patients with acute ischemic stroke (AIS) due to atrial fibrillation (Afib) may not respond as well to intravenous thrombolysis (IVT) compared to those without Afib, resulting in poor outcomes. This study compares the length of stay (LOS) at the hospital and discharge disposition (home, inpatient rehabilitation, nursing home facility, or death) in patients receiving acute stroke treatment with IVT and/or thrombectomy (EVT) in Afib and non-Afib groups. Methods: Data from a multi-state health system’s stroke registry for patients who received acute stroke treatment and were discharged between 2018 and 2022 were used. Patients were stratified into three groups: 1, EVT only with or without history of Afib; 2, IVT plus EVT with or without history of Afib; 3, IVT only with or without history of Afib.Multivariable mixed-effect regressions were performed to evaluate if patients with Afib had an effect on LOS or discharge disposition within the three treatment groups adjusting for patient age, sex, race and ethnicity, NIHSS on admission, blood glucose on admission, SBP on admission, and history of diabetes, CAD/prior MI, carotid stenosis, smoking, dyslipidemia, heart failure, being overweight, or renal insufficiency. Results: Among patients with AIS, the median age at arrival was 72 years, 51% male, 70% white, and non-Hispanic; the median NIH Stroke scale was 9.Discharge disposition and LOS were assessed in a cohort of 7820 patients: In group 1(EVT, n: 2388): 37.4% had Afib and 53.3% discharged home, median LOS 5.42 days. In group 2(IVT/EVT, n: 978): 28.5% had Afib and 58.8% discharged home , median LOS 4.25 days. Among group 3(IVT, n: 4454) 14.4% had Afib and 67.8% discharged home, median LOS 2.90 days. After adjustment, there was no association between Afib and either outcome in the three treatment groups. Conclusions: The history of Afib in a patient with AIS does not have a significant negative impact on the LOS or discharge disposition.