Seizure and outcome in patient undergoing mechanical thrombectomy for acute ischemic stroke: A look at the pre-retrieval stent FDA approval.
Abstract number :
832
Submission category :
16. Epidemiology
Year :
2020
Submission ID :
2423166
Source :
www.aesnet.org
Presentation date :
12/7/2020 9:07:12 AM
Published date :
Nov 21, 2020, 02:24 AM
Authors :
Yael Pinero Colon, Penn State Health Milton S. Hershey Medical Center; Alain Lekoubou Looti - Penn State Health Milton S. Hershey Medical Center; Bruce Ovbiagele - VA Healthcare system; kinfe bishu - Medical University of South Carolina;
Rationale:
Mechanical thrombectomy (MT) has become the standard of care for patients with acute ischemic stroke due to large vessel occlusion (LVO). With the increasing use of MT, clinicians are more likely to encounter seizures, a potential complication of ischemic stroke treated with MT. Future evaluation of the burden and trends of post-stroke seizure associated with this therapeutic modality will require pre-approval benchmark estimates of the prevalence of seizures and their impact on mortality.
Method:
All patients with acute ischemic stroke who underwent MT (International Classification of Diseases, Ninth Revision, Clinical Modification; ICD-9-CM procedure code: 39.74) were identified from the National Inpatient Sample (NIS) 2006-2014, using appropriate ICD-9-CM codes. We identified a subset of patients with seizures using ICD-9-CM secondary discharge diagnoses codes 780.3x and 345.x. We computed the rate of seizures overall and across pre-specified demographic, clinical, and healthcare system-related variables. Finally, we assessed the independent association of mortality with seizures, using a multivariable logistic regression model, adjusting for potential confounders.
Results:
Out of a total of 30137 (weighted) patients with acute ischemic stroke who underwent MT, 1,363 (4.5%) had seizures. Patients who had seizures were younger, privately insured, or Medicaid beneficiaries, and frequently died in the hospital. There was no statistically significant difference between both by race, gender, IV thrombolysis with recombinant tissue plasminogen activator, length of stay, and the number of medical comorbidities. In the logistic regression model, patients who underwent MT and developed seizures had 75% higher odds of in-hospital mortality (adjusted OR 95% CI 1.22-2.49, p=0.002).
Conclusion:
In this national sample, prior to its approval, seizures was observed in 4.5% of all patients with ischemic stroke who were treated with MT and the presence of seizure was independently associated with a nearly two-fold increase in the odds of in-hospitality death.
Funding:
:None
Epidemiology