National trends in endovascular thrombectomy and decompressive craniectomy for acute ischemic stroke: A study using National Inpatient Sample data from 2006 to 2016

Nicholas Gravbrot, Riley McDougall, Pedro Aguilar-Salinas, Mauricio J. Avila, Aaron R. Burket, Travis M. Dumont

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Ischemic stroke is a frequently encountered neurologic process with wide-spanning impact. A dreaded complication is “malignant” cerebral edema, necessitating decompression to reduce herniation risk. Following the publication of several landmark trials in 2015, endovascular thrombectomy (EVT) with novel clot-removal devices has emerged as an effective treatment for proximal large vessel disease. Herein, we examine recent national trends in EVT and decompressive craniectomy (DC) rates for acute stroke. Methods: National Inpatient Sample data were abstracted from 2006 to 2016. Primary outcomes were EVT and DC rates, compared using Cochrane-Armitage test of trend. Chi-square test was also used to compare data from 2015 to 2016. Secondary outcomes included inpatient mortality and home discharge rates. Results: EVT rates steadily increased from 2006 to 2016, with most change occurring from 2014 to 2016 (1.36% in 2014, 2.29% in 2016). DC rates similarly increased from 2006 to 2015, though a sharp decline was observed in 2016 (0.42% in 2015, 0.22% in 2016). Test of trend from 2006 to 2016 for both variables was found to be statistically significant (p = 0.001); DC rate change from 2015 to 2016 was also statistically significant (p < 0.01). Mortality rate and home discharge rate steadily improved over the study period. Conclusions: Recent innovation in stroke treatment has led to increased EVTs. While DC rate initially followed this same trend, a significant decline was noted in 2016, around the time that wider adoption of novel EVT technologies were instituted in clinical practice.

Original languageEnglish (US)
Pages (from-to)234-238
Number of pages5
JournalJournal of Clinical Neuroscience
Volume101
DOIs
StatePublished - Jul 2022

Keywords

  • Craniectomy
  • Decompressive craniectomy
  • National Inpatient Sample
  • Stroke
  • Thrombectomy

ASJC Scopus subject areas

  • Surgery
  • Neurology
  • Clinical Neurology
  • Physiology (medical)

Fingerprint

Dive into the research topics of 'National trends in endovascular thrombectomy and decompressive craniectomy for acute ischemic stroke: A study using National Inpatient Sample data from 2006 to 2016'. Together they form a unique fingerprint.

Cite this