More than half of the patients suffering from acute ischemic stroke have minor neurological defects. However, the frequency and outcomes of reperfusion therapy in clinical practice have not been well-defined. The primary outcomes of this study included excellent discharge disposition (discharge to home without assistance), low discharge disposition (dismissal to facility or death); in-hospital mortality; and radiological intracranial hemorrhage.
Among the 180k acute ischemic stroke admits during the 15-month study period, 57.7% had mild strokes. Considering the reperfusion therapies among strokes with documented NIHSS, 10.7% of mechanical thrombectomy procedures and mild deficit hospitalizations accounted for 40.0% of IVT. The characteristics associated with IVT and automated thrombectomy utilization were higher NIHSS score, absence of diabetes, more considerable/teaching hospital status, younger age, and Western US region. Excellent discharge outcomes occurred in 48.2% of all mild strokes. In multivariable analysis, it was associated with younger age, male sex, the White race, lower NIHSS score, absence of diabetes, heart failure, and kidney disease, and IVT use.
More than one-half of acute ischemic stroke hospitalizations had mild deficits in national US practice, accounting for 4 of every 10 IVT and one out of ten mechanical thrombectomy treatments. However, IVT use is found to be associated with increased discharge home despite the increased intracranial hemorrhage.
Ref: https://www.ahajournals.org/doi/10.1161/STROKEAHA.120.030898
