Between-center variation in outcome after endovascular treatment of acute stroke: Analysis of two nationwide registries
Circulation: Cardiovascular Quality and Outcomes — Janssen PM, van Overhagen K, Vinklárek J, et al. | February 02, 2022
Considering the relevance of understanding the differences in patient outcomes between endovascular thrombectomy (EVT) centers for improving stroke care, researchers herein investigated between-center variation in functional outcome of patients with acute ischemic stroke who were treated with EVT. Further, they assessed the extent to which modifiable center characteristics may explain this variation.
Data of patients with stroke treated with EVT were retrieved using the nationwide registry in the Netherlands and in the Czech Republic.
A total of 4,518 patients treated in 33 centers were included.
Researchers expressed between-center variation as the relative difference in odds of a more favorable modified Rankin Scale score between a relatively better performing center (75th percentile) and a relatively worse performing center (25th percentile).
Following adjustment for patient characteristics, there appeared 1.46 times higher odds of a more favorable outcome in a center at the 75th percentile of the outcome distribution compared with the odds in a center at the 25th percentile.
Center-specific characteristics, such as time to reperfusion, could largely explain the considerable between-center variation in patient outcomes after EVT for acute ischemic stroke.
A decrease in center-specific differences, and an overall improvement in outcome of patients with acute ischemic stroke may occur in correlation with an improvement in the parameters.