Abstract TP29: Endovascular Thrombectomy in In-Hospital Stroke Patients

Abstract

Background and Purpose: Outcome of in-hospital stroke (IHS) patients is reported to be poor because of having other diseases as malignancy, cardiac, kidney and pulmonary diseases. IHS accounts for 5% of all ischemic strokes. Recent endovascular thrombectomy (EVT) can dramatically improve the clinical outcome of acute large artery occlusion(LVO) patients. However, it is not clear whether EVT can improve the outcome of HIS patients with LVO. Methods: Our prospective stroke registry between 2014 and 2019 were retrospectively reviewed. Among them, we enrolled acute stroke patients with LVO treated with EVT. We classified two group; IHS group; had IHS patients and outside hospital onset stroke (OHS) group; stroke onset was outside of our hospital and were directly admitted to our hospital. We compared clinical background and patient outcome at 3 months between two groups. Favorable outcome was identified as mRS 0-2 at 3 months. Results: Among 225 EVT patients((age 79 years [68-83], male 140 [62%], NIHSS score 15 [8-21]), 27 and 198 patients were classified to the IHS group and OHS group, respectively. Age, gender, initial NIHSS score was similar between IHS and OHS group (P=0.891, 1.000, and 0.146). ICA occlusion tended to be infrequent in the IHS group (11% vs. 26%, P=0.098), while distal MCA occlusion tended to be frequent (41% vs. 25%, P=0.107). Successful reperfusion was achieved in 82% in the IHS group and in 84% in the OHS group (P=0.780). Favorable outcome at 3 months was similar between two groups (39% in the IHS group and 51% in the OHS group, P=0.457). Conclusion: Patient outcome at 3 months in IHS patients with LVO was similar to OHS patients. In hospital stroke patients with LVO, EVT should improve the patient outcome as well as OHS patients. Thus, EVT in HIS patients with LVO should be performed without hesitation.