Stroke thrombectomy volume, rather than stroke center accreditation status of hospitals, is associated with mortality and discharge disposition

Authors

Muhammad Waqas, Department of Neurosurgery, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, USA.
Vincent M. Tutino, Department of Neurosurgery, Pathology and Anatomical Sciences, and Canon Stroke and Vascular Research Center, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, USA.
Justin M. Cappuzzo, Department of Neurosurgery, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, USA.
Victoria Lazarov, Medical Student, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, USA.
Daniel Popoola, Medical Student, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, USA.
Tatsat R. Patel, Department of Biomedical Engineering, University at Buffalo, Buffalo, New York, USA.
Bennett R. Levy, Medical Student, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA.
Andre Monteiro, Department of Neurosurgery, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, USA.
Maxim Mokin, Department of Neurosurgery and Brain Repair, University of South Florida, Tampa, Florida, USA.
Ansaar T. Rai, Department of Interventional Neuroradiology, West Virginia University Rockefeller Neuroscience Institute, Morgantown, West Virginia, USA.
J Mocco, Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Aquilla S. Turk, Department of Neurosurgery, Prisma Health Upstate, Greenville, South Carolina, USA.
Kenneth V. Snyder, Department of Neurosurgery, Gates Vascular Institute, Buffalo, New York, USA.
Jason M. Davies, Department of Neurosurgery, Gates Vascular Institute, Buffalo, New York, USA.
Elad I. Levy, Department of Neurosurgery, Gates Vascular Institute, Buffalo, New York, USA.
Adnan H. Siddiqui, Department of Neurosurgery, Gates Vascular Institute, Buffalo, New York, USA asiddiqui@ubns.com.

Document Type

Journal Article

Publication Date

3-1-2022

Journal

Journal of neurointerventional surgery

DOI

10.1136/neurintsurg-2021-018079

Keywords

stroke; thrombectomy

Abstract

BACKGROUND: Few studies have explored the association between stroke thrombectomy (ST) volume and hospital accreditation with clinical outcomes. OBJECTIVE: To assess the association of ST case volume and accreditation status with in-hospital mortality and home discharge disposition using the national Medicare Provider Analysis and Review (MEDPAR) database. METHODS: Rates of hospital mortality, home discharge disposition, and hospital stay were compared between accredited and non-accredited hospitals using 2017-2018 MEDPAR data. The association of annual ST case volume with mortality and home disposition was determined using Pearson's correlation. Median rate of mortality and number of ST cases at hospitals within the central quartiles were estimated. RESULTS: A total of 29 355 cases were performed over 2 years at 847 US centers. Of these, 354 were accredited. There were no significant differences between accredited and non-accredited centers for hospital mortality (14.8% vs 14.5%, p=0.34) and home discharge (12.1% vs 12.0%, p=0.78). A significant positive correlation was observed between thrombectomy volume and home discharge (r=0.88; 95% CI 0.58 to 0.97, p=0.001). A significant negative relationship was found between thrombectomy volume and mortality (r=-0.86; 95% CI -0.97 to -0.49, p=0.002). Within the central quartiles, the median number of ST cases at hospitals with mortality was 24/year, and the median number of ST cases at hospitals with home discharge rate was 23/year. CONCLUSION: A higher volume of ST cases was associated with lower mortality and higher home discharge rate. No significant differences in mortality and discharge disposition were found between accredited and non-accredited hospitals.

APA Citation

Waqas, Muhammad; Tutino, Vincent M.; Cappuzzo, Justin M.; Lazarov, Victoria; Popoola, Daniel; Patel, Tatsat R.; Levy, Bennett R.; Monteiro, Andre; Mokin, Maxim; Rai, Ansaar T.; Mocco, J; Turk, Aquilla S.; Snyder, Kenneth V.; Davies, Jason M.; Levy, Elad I.; and Siddiqui, Adnan H., "Stroke thrombectomy volume, rather than stroke center accreditation status of hospitals, is associated with mortality and discharge disposition" (2022). GW Authored Works. Paper 678.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/678

Department

School of Medicine and Health Sciences Student Works