Abstract WP212: Site vs. Core Lab Adjudicated eTICI Scores Compared During Off and Normal Hours - Insights From the ASSIST Registry

Abstract

Introduction: The ASSIST registry is a prospective, global registry whose primary aim was to identify which endovascular technique yields the highest rate of first pass TICI 2C reperfusion. Data from this registry was analyzed for this secondary analysis to assess if site adjudicated eTICI scores differ from the core lab during off hours [7 PM to 6:59 AM plus weekends (7 PM Friday - 6:59 AM Monday)] compared to normal hours (7 AM - 6:59 PM on weekdays). An additional objective is to assess if outcomes are worse with regards to core-lab adjudicated reperfusion grades and mRS 0-2 in procedures performed during off hours. Methods: Details from the ASSIST registry have been previously presented. Descriptive statistics for outcomes and percent agreement between core-lab and site-reported eTICI were calculated. Regression models were performed for first pass treatment of target occlusion resulting in ≥ 2c by core-lab, mRS 0-2 at 90 days, and whether first pass eTICI agreed for both core-lab and site-reported. Results: A total of 1318 patients were included in the analysis with 652 patients presenting during normal hours and 666 patients presenting during off hours. Overall, agreement between core-lab and site-reported eTICI at first pass occurred in 86.7% and 78.5% for final eTICI ≥2c. Agreement occurred for first pass eTICI ≥2c 87.2% during normal hours and 86.1% during off hours. Agreement occurred less often on final pass eTICI ≥2c during both normal and off hours (77.7% and 79.3%, respectively). Good functional outcomes based on 90-day mRS 0-2 occurred in 55.5% in patients presenting during normal hours and 53.8% in patients presenting during off hours. Off-hour vs. normal hour procedures was not significantly associated with first pass efficacy, mRS 0-2 at 90 days, or whether first pass eTICI agreed for both core-lab and site-reported in adjusted regression analyses. Conclusions: There was a higher level of agreement between core-lab and site-reported first pass eTICI scores during all hours while agreement occurred less often for final reperfusion. These results suggest a high level of correlation with site adjudicated and core lab adjudicated successful reperfusion grading. ClinicalTrials.gov ID: NCT03845491