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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Real-World Outcomes of Endovascular Thrombectomy for Basilar Artery Occlusion: Results of the BArONIS Study
Annals of Neurology, Volume 94, No. 1, Year 2023
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Description
Objective: To evaluate clinical outcomes of endovascular thrombectomy (EVT) for acute basilar artery occlusion (BAO) using population-level data from the United States. Methods: Weighted discharge data from the National Inpatient Sample were queried to identify adult patients with acute BAO during the period of 2015 to 2019 treated with EVT or medical management only. Complex samples statistical methods and propensity-score adjustment using inverse probability of treatment weighting (IPTW) were performed to assess clinical endpoints. Results: Among 3,950 BAO patients identified, 1,425 (36.1%) were treated with EVT [mean age 66.7 years, median National Institute of Health Stroke Scale (NIHSS) score 22]. On unadjusted analysis, 155 (10.9%) EVT patients achieved favorable functional outcomes (discharge disposition to home without services), while 515 (36.1%) experienced in-hospital mortality, and 20 (1.4%) developed symptomatic intracranial hemorrhage (sICH). Following propensity-score adjustment by IPTW accounting for age, stroke severity, and comorbidity burden, EVT was independently associated with favorable functional outcome [adjusted odds ratio (aOR) 1.25, 95% confidence interval (CI) 1.07, 1.46; p = 0.004], but not with in-hospital mortality or sICH. In an IPTW-adjusted sub-group analysis of patients with NIHSS scores >20, EVT was associated with both favorable functional outcome (discharge disposition to home or to acute rehabilitation) (aOR 1.55, 95% CI 1.24, 1.94; p < 0.001) and decreased mortality (aOR 0.78, 95% CI 0.69, 0.89; p < 0.001), but not with sICH. Interpretation: This retrospective population-based analysis using a large national registry provides real-world evidence of a potential benefit of EVT in acute BAO patients. ANN NEUROL 2023;94:55–60. © 2023 American Neurological Association.
Authors & Co-Authors
Dicpinigaitis, Alis J.
United States, Valhalla
New York Medical College
Kamal, Haris
United States, Valhalla
Westchester Medical Center
Ghozy, Sherief A.
United States, Rochester
Mayo Clinic
Kaur, Gurmeen
United States, Valhalla
Westchester Medical Center
Desai, Shashvat M.
United States, Phoenix
Barrow Neurological Institute
Ortega‑Gutierrez, Santiago
United States, Iowa City
University of Iowa Healthcare
Yaghi, Shadi R.
United States, Providence
Rhode Island Hospital
Jadhav, Ashutosh Prabhakar
United States, Phoenix
Barrow Neurological Institute
Hassan, Ameer E.
Unknown Affiliation
Nguyen, Thanh Ngoc
United States, Boston
Boston Medical Center
Mayer, Stephan A.
United States, Valhalla
Westchester Medical Center
Jovin, Tudor G.
United States, Camden
Cooper University Hospital
Nogueira, Raul Gomes
United States, Pittsburgh
University of Pittsburgh School of Medicine
Gandhi, Chirag D.
United States, Valhalla
Westchester Medical Center
Al-Mufti, Fawaz
United States, Valhalla
Westchester Medical Center
Statistics
Citations: 2
Authors: 15
Affiliations: 10
Identifiers
Doi:
10.1002/ana.26640
ISSN:
03645134
Research Areas
Disability
Health System And Policy
Noncommunicable Diseases
Study Design
Cross Sectional Study
Cohort Study
Case-Control Study