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. 2023 Aug;32(8):107171.
doi: 10.1016/j.jstrokecerebrovasdis.2023.107171. Epub 2023 May 4.

Mortality following mechanical thrombectomy for ischemic stroke in patients with COVID-19

Jonathan Dallas  1 , Talia A Wenger  2 , Kristie Q Liu  2 , Li Ding  3 , Benjamin S Hopkins  4 , Frank J Attenello  4 , William J Mack  4
Affiliations

Mortality following mechanical thrombectomy for ischemic stroke in patients with COVID-19

Jonathan Dallas et al. J Stroke Cerebrovasc Dis. 2023 Aug.

Abstract

Objectives: Multiple prior studies have shown a relationship between COVID-19 and strokes; further, COVID-19 has been shown to influence both time-to-thrombectomy and overall thrombectomy rates. Using large-scale, recently released national data, we assessed the association between COVID-19 diagnosis and patient outcomes following mechanical thrombectomy.

Materials and methods: Patients in this study were identified from the 2020 National Inpatient Sample. All patients with arterial strokes undergoing mechanical thrombectomy were identified using ICD-10 coding criteria. Patients were further stratified by COVID diagnosis (positive vs. negative). Other covariates, including patient/hospital demographics, disease severity, and comorbidities were collected. Multivariable analysis was used to determine the independent effect of COVID-19 on in-hospital mortality and unfavorable discharge.

Results: 5078 patients were identified in this study; 166 (3.3%) were COVID-19 positive. COVID-19 patients had a significantly higher mortality rate (30.1% vs. 12.4%, p < 0.001). When controlling for patient/hospital characteristics, APR-DRG disease severity, and Elixhauser Comorbidity Index, COVID-19 was an independent predictor of increased mortality (OR 1.13, p = 0.002). COVID-19 was not significantly related to discharge disposition (p = 0.480). Older age and increased APR-DRG disease severity were also correlated with increase morality.

Conclusions: Overall, this study indicates that COVID-19 is a predictor of mortality among mechanical thrombectomy. This finding is likely multifactorial but may be related to multisystem inflammation, hypercoagulability, and re-occlusion seen in COVID-19 patients. Further research would be needed to clarify these relationships.

Keywords: COVID-19; Coronavirus; Mortality; Stroke; Thrombectomy.

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Conflict of interest statement

Declaration of Competing Interest None.

Figures

Fig 1
Fig. 1
Flowchart detailing patient selection criteria.
See this image and copyright information in PMC

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