Abstract WP250: Trends in Outcomes Associated With Thrombectomy Treatment Among Acute Ischemic Stroke Patients: Retrospective Analysis of 2011-2017 Premier Hospital Database

Abstract

Objectives: Mechanical thrombectomy has become the cornerstone of acute ischemic stroke (AIS) treatment. This study evaluated trends in discharge status, length of stay (LoS), operating room (OR) time, readmissions and costs among AIS patients who underwent mechanical thrombectomy treatment. Methods: This retrospective cohort study used 2011-2017Q3 Premier Healthcare Database to evaluate discharge status, length of stay (LoS), operating room (OR) time, readmissions, index inpatient costs for AIS patients aged ≥18 years who underwent mechanical thrombectomy. Patients with a diagnosis of AIS in 12-month baseline or with LoS ≤ 1 day were excluded. The Mann-Kendall statistic was used to examine trends in economic and clinical outcomes associated with thrombectomy between 2011 and 2017. Results: Among 505,824 patients identified with a primary diagnosis of AIS between 2011 and 2017, 11,811 (2.34%) patients were treated with mechanical thrombectomy. The percentage of AIS patients who underwent thrombectomy significantly increased from 1.33% in 2011 to 4.44% in 2017 (p<0.01). The mean age of patients was 66.47 ± 14.75 years, with 51.97% being male. Among AIS patients who underwent thrombectomy, the discharge to home significantly increased from 17.69% in 2011 to 29.64% in 2017 (p< 0.01), while discharge to long-term facility decreased from 53.47% to 49.69% (p=0.10). Mortality rate significantly decreased from 21.60% to 12.64% during the same time period (p< 0.01). The mean OR time declined from 200.73 minutes (2011) to 170.11 minutes (2017) while LoS significantly decreased by 2.95 days (p< 0.01). All-cause 365-day readmission rate decreased from 24.15% in 2011 to 19.78% in 2017 (P=0.35). The index inpatient hospital cost of AIS patients who received thrombectomy significantly declined from $50,516.54 to $42,026.90 (p< 0.01). Conclusions: The economic and clinical outcomes among AIS patients receiving mechanical thrombectomy treatment improved during the study period. However, the overall burden of stroke among patients who received thrombectomy remains high.