Abstract WP154: Factors Associated With Prolonged Length of Intensive Unit Stay Following Mechanical Thrombectomy for Acute Ischemic Stroke

Abstract

Objective and Background: The objective of the study was to investigate factors affecting the length of stay (LOS) in the intensive care unit (ICU) following mechanical thrombectomy (MT) for acute ischemic stroke. Methods: We identified patients undergoing MT from a prospective registry at a comprehensive stroke center between January 2021 and June 2023. ICU stay for more than 48 hours was defined as prolonged ICU stay. Results: Out of 363 patients, 41.6% (n=151) required a prolonged ICU stay. Prolonged ICU stay were more likely to have higher baseline median NIHSS score (19 vs. 14%, p < 0.0001), posterior circulation stroke (12.6% vs. 5.7%, p = 0.0200), intubation for the procedure (86.7% vs. 69.3%, p = 0.0001), complications including pneumonia (18.5% vs. 6.1%, p = 0.0002), deep vein thrombosis (7.3 vs. 2.3, p = 0.0242), urinary tract infection (12.6% vs. 6.1%, p = 0.0326), and symptomatic intracerebral hemorrhage (7.3% vs. 1.9%, p = 0.0109). Patients receiving thrombolysis prior to thrombectomy were less likely to have a prolonged LOS (27.8% vs. 41.7%, p = 0.0086). Independent predictors for prolonged ICU LOC included higher NIHSS (odds ratio [OR] 2.7, p = 0.0002), intubation prior to the procedure (OR 2.7, p = 0.0002), not receiving IV thrombolysis (OR 2.3, p = 0.0069), thrombolysis in cerebral infarction (TICI) score ≥ 2B (OR 0.458, p = 0.0754), composite ICU complications (OR 2.4, p = 0.0027), and symptomatic intracranial hemorrhage (OR 5.2, p = 0.0157). Conclusions: Almost one-third of the acute ischemic stroke patients required a prolonged ICU stay following MT. A better understanding of the factors associated with prolonged ICU stay may assist in appropriate allocation of resources.