Ramsay, Ian A;
Fountain, Hayes;
Elarjani, Turki;
Govindarajan, Vaidya;
Silva, Michael;
Abdelsalam, Ahmed;
Burks, Joshua D;
Starke, Robert M;
Luther, Evan
Outcomes in patients with large vessel occlusion strokes undergoing mechanical thrombectomy with concurrent COVID-19: a nationwide retrospective analysis
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Media type:
E-Article
Title:
Outcomes in patients with large vessel occlusion strokes undergoing mechanical thrombectomy with concurrent COVID-19: a nationwide retrospective analysis
Contributor:
Ramsay, Ian A;
Fountain, Hayes;
Elarjani, Turki;
Govindarajan, Vaidya;
Silva, Michael;
Abdelsalam, Ahmed;
Burks, Joshua D;
Starke, Robert M;
Luther, Evan
imprint:
BMJ, 2024
Published in:Journal of NeuroInterventional Surgery
Description:
<jats:sec><jats:title>Background</jats:title><jats:p>Preliminary studies show that patients with large vessel occlusion (LVO) acute ischemic strokes have worse outcomes with concurrent COVID-19 infection. We investigated the outcomes for patients with LVO strokes undergoing mechanical thrombectomy (MT) with concurrent COVID-19 infection.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>The National Inpatient Database (NIS) was used for our analysis. Patients in the year 2020 with an ICD-10 diagnosis code for acute ischemic stroke and procedural code for MT were included with and without COVID-19. Odds ratios (OR) were calculated using a logistic regression model with age, sex, stroke location, Elixhauser comorbidity score, and other patient variables deemed clinically relevant as covariates.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Patients in the COVID-19 group were younger (64.3±14.4 vs 69.4±14.5 years, P<0.001), had a higher rate of inpatient mortality (22.4% vs 10.1%, P<0.001), and a longer length of stay (10 vs 6 days, P<0.001). Patients with COVID-19 had higher odds of death (OR 2.78, 95% CI 2.11 to 3.65) and lower odds of a routine discharge (OR 0.65, 95% CI 0.48 to 0.89). There was no difference in the odds of subsequent stroke and cerebral hemorrhage, but patients with COVID-19 had statistically significantly higher odds of respiratory failure, pulmonary embolism, deep vein thrombosis, myocardial infarction, acute kidney injury, and sepsis.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>Patients with LVOs undergoing MT within the 2020 NIS database had worse outcomes when co-diagnosed with COVID-19, likely due to non-neurological manifestations of COVID-19.</jats:p></jats:sec>