Evaluating outcome associations with race after mechanical thrombectomy: an analysis of the NVQI-QOD acute ischemic stroke registry.

Autor:	Fuentes A; Department of Neurosurgery, University of Virginia, Charlottesville, Virginia, USA., Thirunavu V; Department of Radiology, Neurology, and Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA., Hasib Akhter Faruqui S; Department of Radiology, Neurology, and Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA., Zhou C; Department of Radiology, Neurology, and Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA., McGuire LS; Department of Neurosurgery, University of Illinois at Chicago, Chicago, Illinois, USA., Du X; Department of Neurosurgery, University of Illinois at Chicago, Chicago, Illinois, USA., Pandey D; Department of Neurology, University of Illinois at Chicago, Chicago, Illinois, USA., Cantrell D; Department of Radiology, Neurology, and Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA., Ansari SA; Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA., Amin-Hanjani S; Department of Neurosurgery, University of Illinois at Chicago, Chicago, Illinois, USA sepideh.hanjani@uhhospitals.org.; Department of Neurosurgery, University Hospitals Cleveland Medical Center/ Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.
Jazyk:	angličtina
Zdroj:	Journal of neurointerventional surgery [J Neurointerv Surg] 2024 Jan 03. Date of Electronic Publication: 2024 Jan 03.
DOI:	10.1136/jnis-2023-021208
Abstrakt:	Background: Mechanical thrombectomy has become the standard of care for acute ischemic stroke due to large vessel occlusions. Racial differences in outcomes after mechanical thrombectomy for acute ischemic stroke have not been extensively studied. We evaluate the real-world evidence for differences between races in the outcomes of thrombectomy for large vessel occlusions using the NeuroVascular Quality Initiative-Quality Outcomes Database (NVQI-QOD). Methods: Data from the NVQI-QOD acute ischemic stroke registry were analyzed and compared for racial differences in outcomes after mechanical thrombectomy in 4507 patients from 28 US centers (17 states) between January 2014 and April 2021. Race was dichotomized into non-Hispanic White (NHW, n=3649) and non-Hispanic Black (NHB, n=858). We performed 1:1 propensity score matching resulting in a subsample of matched groups (n=761 each for NHB and NHW) to compare study endpoints using Welch's two-sided t-tests and Χ 2 test for continuous and categorical outcomes, respectively. Results: Prior to matching, NHW and NHB patients significantly differed in age, comorbidities, medication use, smoking status, and presenting stroke severity. No significant difference in functional outcomes or mortality, at discharge or follow-up, were revealed. NHB patients had higher average postprocedure length of stay than NHW patients, which persisted following matching (11.2 vs 9.1 days, P=0.004). Conclusion: Evidence from the NVQI-QOD acute ischemic stroke registry showed that outcome metrics, such as modified Rankin Scale score and mortality, did not differ significantly between racial groups; however, disparity between NHW and NHB patients in postprocedure length of stay following mechanical thrombectomy was revealed. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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