Statewide trends in endovascular utilization and outcomes: analysis of the Minnesota Hospital Association data, 2014-2015 [abstract] Abstract uri icon
  • Objective: The aim of this study is to examine the changes in endovascular procedures utilization after the publication of the recent clinical trials showing benefit of such procedures in patients with acute ischemic stroke. Background: There is emphasis on understanding the implementation of clinical trial results for clinical practice. Design/Methods: Minnesota Hospital Association (MHA) database was used to calculate the statewide utilization rates for two periods: prior to (January 1 – December 31, 2014) and after (January 1– December 31, 2015) publication of randomized clinical trials. MHA collects quality data from 137 member hospitals across the state. Patients were identified using ICD9 or ICD10 codes (ICD10 started October 2015).Utilization rates for endovascular treatment were calculated monthly, quarterly, and annually. Patients who were discharged home were considered to have no to minimal disability. Results: Of the 13,043 patients admitted with acute ischemic stroke, 434 patients (mean age 68.5±25.5 years; 51.2% women) received endovascular treatment. The number of procedures increased from 194 in 2014 to 240 in 2015. Utilization rate was 3.4% in the first quarter of 2014, gradually declined to reach its lowest value (2.6%) the last quarter of 2014, then steadily increased to reach its peak(4%) in the last quarter of 2015. Procedures performed at comprehensive stroke centers increased from 52% of total procedures in 2014 to 57.5% in 2015 while those performed at primary stroke centers decreased from 22.6% to 19.5%. In 2015,fewer patients had hypertension (50.4% vs. 60.3%; p=0.039) and more patients had chronic kidney disease (28.3% vs. 15.5%; p=0.001) compared to 2014. Intracranial hemorrhage, mortality rate, and rate of home discharge were not significantly different between the two years. Conclusions: We observed a state wide increase in rate of utilization of endovascular treatment of acute ischemic stroke patients coinciding with the publication of the results of new clinical trials.

  • publication date
  • 2017
  • published in
  • Neurology  Journal
  • Research
  • Cardiovascular Diseases
  • Hospitalization
  • Physician's Practice Patterns
  • Stroke
  • Surgery
  • Additional Document Info
  • 88
  • issue
  • 16 Suppl