Factors Associated with Prolonged Length of Intensive Unit Stay Following Mechanical Thrombectomy for Acute Ischemic Stroke
Saqib Chaudhry1, Maham Laleka1, Hamza Khan1, Mohammad Rauf Chaudhry2, Muhammad Taimoor Khan1, Mohammad Wajih Baig3, Adnan Qureshi4, Ashfaq Shuaib5
1Neurology, Inova Fairfax Medical Campus, 2Neurology, Inova Loudoun Hospital, 3Internal Medicine, Tower Health Hospital, 4Neurology, Zeenat Qureshi Stroke Institute, 5Neurology, University of Alberta
Objective:
The objective of the study was to investigate factors affecting the length of stay (LOS) in the intensive care unit (ICU) following mechanical thrombectomy (MT) for acute ischemic stroke.
Design/Methods:
We identified patients undergoing MT from a prospective registry at a comprehensive stroke center between January 2021 and June 2023. ICU stay for more than 48 hours was defined as prolonged ICU stay.
Results:
Out of 363 patients, 41.6% (n=151) required a prolonged ICU stay. Prolonged ICU stay were more likely to have higher baseline median NIHSS score (19 vs. 14%, p < 0.0001), posterior circulation stroke (12.6% vs. 5.7%, p = 0.0200), intubation for the procedure (86.7% vs. 69.3%, p = 0.0001), complications including pneumonia (18.5% vs. 6.1%, p = 0.0002), deep vein thrombosis (7.3 vs. 2.3, p = 0.0242), urinary tract infection (12.6% vs. 6.1%, p = 0.0326), and symptomatic intracerebral hemorrhage (7.3% vs. 1.9%, p = 0.0109). Patients receiving thrombolysis prior to thrombectomy were less likely to have a prolonged LOS (27.8% vs. 41.7%, p = 0.0086). Independent predictors for prolonged ICU LOC included higher NIHSS (odds ratio [OR] 2.7, p = 0.0002), intubation prior to the procedure (OR 2.7, p = 0.0002), not receiving IV thrombolysis (OR 2.3, p = 0.0069), thrombolysis in cerebral infarction (TICI) score ≥ 2B (OR 0.458, p = 0.0754), composite ICU complications (OR 2.4, p = 0.0027), and symptomatic intracranial hemorrhage (OR 5.2, p = 0.0157).
Conclusions:
Almost one-third of the acute ischemic stroke patients required a prolonged ICU stay following MT. A better understanding of the factors associated with prolonged ICU stay may assist in appropriate allocation of resources.