Statewide Trends in Utilization and Outcomes of Endovascular Treatment of Acute Ischemic Stroke: Analysis of Minnesota Hospital Association Data (2014 and 2015)

被引：5

作者：

Hussein, Haitham M. ^{[1
]}

Saleem, Muhammad A. ^{[1
,2
,3
]}

Qureshi, Adnan I. ^{[2
]}

机构：

[1] Reg Hosp, Comprehens Stroke Ctr, St Paul, MN USA

[2] Zeenat Qureshi Stroke Inst, 519 2nd St N, St Cloud, MN 56303 USA

[3] Mercyhealth, Janesville, WI USA

来源：

JOURNAL OF STROKE & CEREBROVASCULAR DISEASES | 2018年 / 27卷 / 03期

关键词：

Endovascular treatment; intra-arterial treatment for stroke; Minnesota Hospital Association; clinical trials; endovascular utilization; INTRAVENOUS T-PA; IMAGING SELECTION; THROMBECTOMY; TRIAL; GUIDELINES; THERAPY;

D O I：

10.1016/j.jstrokecerebrovasdis.2017.09.056

中图分类号：

Q189 [神经科学];

学科分类号：

071006 ;

摘要：

Background: The study aims at examining the changes in endovascular procedures utilization after the publication of the clinical trials showing their benefit in patients with acute ischemic stroke (AIS). Methods: Minnesota Hospital Association database from 137 member hospitals was used to calculate the statewide utilization rates for 2 periods: prior to (calendar year 2014) and after (calendar year 2015) the publication of multiple randomized clinical trials showing the efficacy of endovascular therapy. Patients were identified using International Classification of Disease, Clinical Modification, 9th revision (ICD-9) or ICD-10 codes (ICD-10 started October 2015). Utilization rates for endovascular treatment were calculated monthly, quarterly, and annually. Results: Of the 13,043 patients admitted with AIS, 434 patients (mean age 68.5 +/- 15.5 years; 51.2% women) received endovascular treatment. The number of procedures increased from 194 in 2014 to 240 in 2015. Utilization rate was 3.4% in the first quarter of 2014, gradually declined to reach its lowest value (2.6%) the last quarter of 2014, then steadily increased to reach its peak (4%) in the last quarter of 2015. Procedures performed at comprehensive stroke centers increased from 52% of total procedures in 2014 to 57.5% in 2015, whereas those performed at primary stroke centers decreased from 22.6% to 19.5%. In 2015, fewer patients had hypertension (50.4% versus 60.3%; P = .039) and more patients had chronic kidney disease (28.3% versus 15.5%; P = .001) compared with 2014. Intracranial hemorrhage, mortality rate, and rate of home discharge were similar between the 2 years. Conclusion: Utilization of endovascular procedures for treatment of AIS has been rapidly influenced by medical literature.

引用

页码：677 / 681

页数：5

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