Abstract WP164: National Estimates of Recurrent Ischemic Stroke Among Patients Undergoing Carotid Revascularization: Effect of Treatment Modality

• Published in: Stroke (1970) 2020-02, Vol.51 (Suppl_1)
• Main Authors: Chaudhry, Saqib A, Fang, Yun, Hassan, Ameer E, Akhtar, Iqra N, Chaudhry, Mohammad Rauf A, Gill, Mohsain, Suri, Fareed K, Siddiq, Farhan, Gomez, Camilo R, Qureshi, Adnan I
• Format: Article
• Language: English
• ISSN: 0039-2499; 1524-4628
• DOI: 10.1161/str.51.suppl_1.WP164

Abstract only Background: The estimates of recurrent ischemic stroke in the post-hospitalization period among patients treated for carotid revascularization are not available outside clinical trials (real-world settings). Objective: To determine the rates of ischemic stroke-related hospitalization within 3 months post-hospitalization for treatment of carotid stenosis in a nationwide cohort. Methods: We identified all readmissions related to new ischemic stroke in the nationally representative data for all patients hospitalized for carotid revascularization using the Nationwide Readmissions Database (NRD) 2013 and 2014 for carotid stent placement (CAS) and carotid endarterectomy (CEA). Cox proportional hazards analysis was used to assess the relative risk (RR) of recurrent ischemic stroke for patients in treatment cohorts after adjusting for potential confounders. The survival was estimated for both treatment groups by using Kaplan-Meier survival method. Results: A total of 120, 923patients with carotid stenosis were treated with either CAS (n = 15, 819; 13.1%) or CEA (n = 105,103; 86.9%).- The estimated 3 month recurrent ischemic stroke free survival was 99.2% and 98.9% in patients who underwent CEA and CAS treatments, respectively (p= 0.014). After adjusting for age, and APDRG severity score, the RRs of recurrent any ischemic stroke was higher women (RR, 1.3; 95% confidence interval (CI), 1.1 -1.6), symptomatic patients (RR, 1.5; 95% CI, 1.1 -2.1) and weekend admission (RR, 1.6; 95% CI, 1.1 -2.3). Conclusion: Although the rates of recurrent ischemic stroke-related hospitalization were low among patients undergoing carotid revascularization, there were higher rates among women, symptomatic patients, undergoing carotid stenting and those admitted on weekends.