Endovascular thrombectomy in the 6- to 16-hour time window after the onset of ischemic stroke was found to be associated with reduced hospital stay, more home-time, and a more desirable living situation in the 90 days after stroke, according to study results published in Stroke.
Studies have previously shown endovascular thrombectomy to be effective in the treatment of stroke beyond the accepted 6-hour window from symptom onset. In this study, researchers sought to assess the effect of this treatment on length of hospitalization, home-time, and living situation in the 90 days after stroke.
The current analysis included 182 patients from the DEFUSE 3 trial (Endovascular Therapy Following Imaging Evaluation for Ischemic Stroke 3; ClinicalTrials.gov Identifier: NCT02586415) randomly assigned to endovascular therapy (n=92) or medical therapy (n=90). Of the patients included in the study, 167 survived the acute hospitalization, with a median length of hospital stay of 9.1 days on medical treatment compared with 6.5 days on endovascular therapy (P <.001).
Median home-time for first 90 days poststroke was also improved following endovascular therapy compared with medical therapy (0 days vs 55 days, respectively, P <.001). Furthermore, endovascular therapy was found to be associated with an improved living situation at discharge, 30 days, and 90 days after stroke (P <.001 for all time points).
The researchers acknowledged the study had several limitations, including the inability to adjust for variables that may have had an impact on the post-stroke living situation (eg, level of family support, insurance status) and the fact that patients included in the study were from sites in the United States, limiting the broader application of findings.
“These findings indicate that endovascular therapy not only results in better functional outcomes but also in more favorable living situations associated with improved quality of life,” the investigators concluded. They go on to add that, “[t]he favorable shift in living situation is associated with significant cost savings,” and that the results, “provide valuable data to inform cost-effectiveness studies of endovascular therapy.”
Tate WJ, Polding LC, Kemp S, et al. Thrombectomy results in reduced hospital stay, more home-time, and more favorable living situations in DEFUSE 3 (published online July 10, 2019). Stroke. doi:10.1161/STROKEAHA.119.025165