Abstract
Abstract WMP43: Disparities in Large Vessel Occlusion Stroke Imaging and Endovascular Treatment Metrics, and Procedural Exclusions in the Global Registry of Stroke Care Quality (Res-Q)
Stroke (1970), Vol.55(Suppl_1)
02/2024
DOI: 10.1161/str.55.suppl_1.WMP43
Abstract
Abstract only Introduction: Global access to mechanical thrombectomy for large vessel occlusion (LVO) stroke is low and disparate between regions. Comparative global data on time metrics for imaging and endovascular treatment (EVT) performance, as well as the reasons for excluding EVT, are lacking. Methods: This is a cross-sectional study using quality metrics from the Res-Q registry on patients presenting directly to the hospital with acute ischemic stroke from January 1, 2022, to December 31, 2022, in countries with 200 or more cases. We used descriptive statistical methods to study the time metrics of interest including door to imaging and door to puncture. Additionally, reasons for not performing thrombectomy in patients with LVO were collected (Table 1). Results: Among the 153,181 patients from 912 hospitals across 67 countries enrolled in the Res-Q registry, 125,390 had an acute ischemic stroke. After excluding secondary transfers (n=26,648), patients with missing or erroneous data (n=42,232), and countries with less than 200 cases (n=1,626), data from a total of 54,884 patients from 631 hospitals across 30 countries were analyzed. CT angiography (CTA) was performed in 24,215 (44.1%) patients and EVT was done in 3,649 (6.6%) patients. For patients who had simultaneous CT+CTA, the median door-to-CTA time was 27.5 min (IQR 22.5-33.9) and the median door-to-puncture time was 98.5 (IQR 79.8-129.3) minutes. The most prevalent specific reason for excluding EVT in patients with LVO on CTA/MRA was the presentation in the late time window (42.0%). Only 11 (36.7%) countries achieved a median door-to-puncture time within 90 minutes (Table 1). Conclusions: The performance of acute imaging for LVO detection and time metrics for EVT appear to be disparate between countries and warrant further study. Additional data from global stroke care quality registries are needed to set benchmarks, compare regional stroke systems of care, and identify gaps to mobilize resources appropriately.
Details
- Title: Subtitle
- Abstract WMP43: Disparities in Large Vessel Occlusion Stroke Imaging and Endovascular Treatment Metrics, and Procedural Exclusions in the Global Registry of Stroke Care Quality (Res-Q)
- Creators
- Kaiz S Asif - AscensionRupal Sedani - International Clinical Research Center, St. Anne's University Hospital BrnoNatan M Bornstein - Shaare Zedek Medical CenterMichael D Hill - University of CalgaryPablo M Lavados - Clínica AlemanaSheila C Martins - Hospital de Clínicas de Porto AlegreSandy Middleton - Nursing Rsch Institute, Darlihurst, AustraliaSung-il Sohn - Keimyung UniversityNatalia Jankanicova - International Clinical Research Center, St. Anne's University Hospital BrnoNijasri Suwanwela - Chulalongkorn UniversityP N Sylaja - Sree Chitra Thirunal Institute for Medical Sciences and TechnologyHuy Thang Nguyen - Children's Hospital 1Georgios K Tsivgoulis - National and Kapodistrian University of AthensH B Van Der Worp - University Medical Center UtrechtSantiago Ortega-Gutierrez - University of IowaDileep R Yavagal - University of MiamiRobert Mikulik - St. Anne's University Hospital Brno
- Resource Type
- Abstract
- Publication Details
- Stroke (1970), Vol.55(Suppl_1)
- DOI
- 10.1161/str.55.suppl_1.WMP43
- ISSN
- 0039-2499
- eISSN
- 1524-4628
- Language
- English
- Date published
- 02/2024
- Academic Unit
- Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery
- Record Identifier
- 9984557857902771
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