Abstract Details

Title Factors Associated with Prolonged Hospitalization and In-hospital Mortality in Patients with Large Vessel Occlusion following Endovascular Treatment

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P8 - Poster Session 8 (8:00 AM-9:00 AM)

Poster/Presentation
Number 4-013

Objective To identify factors predicting prolonged hospitalization and in-hospital mortality in patients with acute ischemic stroke and large vessel occlusion (LVO) undergoing endovascular treatment (EVT).

Background Prolonged hospitalization has an inverse relationship with functional outcome in patients with acute ischemic stroke, but data is lacking on patients who undergo endovascular treatment.

Design/Methods EVT patients were identified from a retrospectively collected stroke database maintained at our institution. Patient demographics, comorbidities, hospital and intensive care unit (ICU) length of stay, and mortality data was compiled. We recorded all medical complications during their hospitalization and performed a multivariate regression analysis to identify factors predicting prolonged hospitalization and in-hospital mortality.

Results Between 2015 and 2018, 348 patients underwent EVT at our institution. Mean age was 71 ± 14 years and 47% were women. Median Modified Rankin Scale (mRS) at baseline was 0 (IQR 0-1), median admission and 24-hour post EVT NIHSS was 16 (IQR 11-20) and 12 (IQR 5-19), respectively. Median hospital length of stay was 8 days (IQR 5-14) and ICU length of stay was 2 days (IQR 1-4). Univariate analysis showed patients with prolonged hospitalization had poor functional outcomes at discharge (mRS 4-6, p<0.001). Multivariate analysis showed tracheostomy (p=0.02), feeding tube placement (p<0.001), dialysis (p<0.001), urinary tract infection (p<0.001), NIHSS on admission (p=0.02), and increased number of attempts to reperfusion (p=0.044) were positive predictors of prolonged hospitalization. Intra-arterial tPA (p=0.011), hemorrhagic conversion of stroke (p=0.003), elevated HbA1C on admission (p= 0.018), and higher NIHSS post EVT (p<0.001) were positive predictors of inpatient mortality.

Conclusions Prolonged hospitalization is a predictor of poor functional outcome for EVT patients at discharge. Higher NIHSS on admission, tracheostomy, feeding tube placement, dialysis, and urinary tract infection are positive predictors of prolonged hospitalization. Intra-arterial tPA, hemorrhagic conversion, elevated HbA1C on admission, and higher NIHSS post EVT are positive predictors of in-hospital mortality.

Authors/Disclosures
Nastajjia Krementz, MD (Vascular Neurology - University of Miami/Jackson Health System) PRESENTER	Dr. Krementz has nothing to disclose.
Vasu Saini, MD	Dr. Saini has nothing to disclose.
Vasu Saini, MD	Dr. Saini has nothing to disclose.
Melissa Bailey, MD	Dr. Bailey has nothing to disclose.
Juan Sebastian Diaz, MD (University of Miami, Dept of Neurology)	No disclosure on file
Elizabeth Jordan	No disclosure on file
Mario P. Zamora	Dr. Zamora has nothing to disclose.
Luis Guada-Delgado, MD (University of Miami)	Dr. Guada-Delgado has nothing to disclose.
Daniel R. Kogan, MD (University of Miami/Jackson Memorial Hospital)	No disclosure on file
Nastajjia Krementz, MD (Vascular Neurology - University of Miami/Jackson Health System)	Dr. Krementz has nothing to disclose.
Dileep R. Yavagal, MD, F�鶹��ýӳ�� (University of Miami Miller School of Medicine)	Dr. Yavagal has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Vascular Dynamics. Dr. Yavagal has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Guidepoint. The institution of Dr. Yavagal has received personal compensation in the range of $500-$4,999 for serving as a Consultant for GLG. Dr. Yavagal has received personal compensation in the range of $0-$499 for serving as a Consultant for Medtronic. Dr. Yavagal has received personal compensation in the range of $0-$499 for serving as a Consultant for Cerenovus/Johnson & Johnson. Dr. Yavagal has received personal compensation in the range of $0-$499 for serving as a Consultant for Stryker. Dr. Yavagal has received personal compensation in the range of $0-$499 for serving as a Consultant for Poseydon. Dr. Yavagal has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Athersys. Dr. Yavagal has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Gravity Medical Technology. Dr. Yavagal has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Poseydon. Dr. Yavagal has stock in Poseydon. Dr. Yavagal has stock in Galaxy Therapeutics. Dr. Yavagal has stock in Stentrode. Dr. Yavagal has stock in Gravity Medical. Dr. Yavagal has stock in Gravity Medical Technology. Dr. Yavagal has stock in Athersys. Dr. Yavagal has stock in Rapid Medical . Dr. Yavagal has received intellectual property interests from a discovery or technology relating to health care. Dr. Yavagal has received personal compensation in the range of $5,000-$9,999 for serving as a Medicolegal Expert with Royal Carribean Cruise Line. Dr. Yavagal has received personal compensation in the range of $5,000-$9,999 for serving as a Medicolegal Consultant with Carnival Cruise Line.

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