Outcomes of Blood Transfusions in Patients Undergoing Mechanical Thrombectomy for Acute Ischemic Stroke: A Population-Based Cross-Sectional Study of 47,835 Patients
Abstract
:1. Introduction
2. Materials and Methods
2.1. Data Source and Patient Selection
2.2. Data Characteristics and Outcome Measures
2.3. Statistical Analysis
3. Results
3.1. Complications
3.2. Outcomes
4. Discussion
Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
LVO | Large Vessel Occlusion |
AIS | Acute Ischemic Stroke |
tPA | Tissue Plasminogen Activator |
EVT | Endovascular Thrombectomy |
NIS | National Inpatient Sample |
ICD | International Classification of Disease |
DVT | Deep Vein Thrombosis |
PE | Pulmonary Embolism |
AKI | Acute Kidney Injury |
LOS | Length of Stay |
NIHSS | National Institutes of Health Stroke Scale |
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Variables | Total Cohort (47,835) | Non-Blood Transfusion (46,620, 97.5%) | Blood Transfusion (1215, 2.5%) | Blood Transfusion | |
---|---|---|---|---|---|
OR (CI 95%) | p-Value | ||||
Demographics | |||||
Female | 24,525 (51.3%) | 23,715 (50.9%) | 810 (66.7%) | 1.932 (1.712, 2.179) | <0.001 |
Lower 50th Percentile Median Income | 25,125 (52.5%) | 24,480 (52.5%) | 645 (53.1%) | 1.023 (0.913, 1.147) | 0.705 |
Private Insurance | 10,920 (22.8%) | 10,630 (22.8%) | 290 (23.9%) | 1.061 (0.929, 1.213) | 0.387 |
Medicare Insurance | 29,285 (61.2%) | 28,570 (61.3%) | 715 (58.8%) | 0.903 (0.805, 1.014) | 0.089 |
Medicaid Insurance | 4610 (9.6%) | 4460 (9.6%) | 150 (12.3%) | 1.331 (1.119, 1.584) | 0.001 |
White Race | 32,150 (67.2%) | 31,345 (67.2%) | 805 (66.3%) | 0.957 (0.848, 1.079) | 0.477 |
Comorbidities | |||||
Diabetes Mellitus | 13,005 (27.2%) | 12,695 (27.2%) | 310 (25.5%) | 0.915 (0.803, 1.043) | 0.191 |
Hypertension | 25,000 (52.3%) | 24,500 (52.6%) | 500 (41.2%) | 0.631 (0.562, 0.709) | <0.001 |
Hyperlipidemia | 23,440 (49%) | 22,970 (49.3%) | 470 (38.7%) | 0.65 (0.578, 0.73) | <0.001 |
Obesity | 4755 (9.9%) | 4660 (10%) | 95 (7.8%) | 0.764 (0.618, 0.944) | 0.013 |
Chronic Obstructive Pulmonary Disease | 5565 (11.6%) | 5415 (11.6%) | 150 (12.3%) | 1.072 (0.901, 1.274) | 0.441 |
Congestive Heart Failure | 2330 (4.9%) | 2255 (4.8%) | 75 (6.2%) | 1.294 (1.021, 1.641) | 0.036 |
Smoker Status | 9140 (19.1%) | 8965 (19.2%) | 175 (14.4%) | 0.707 (0.601, 0.831) | <0.001 |
Alcohol Abuse Disorder | 2670 (5.6%) | 2590 (5.6%) | 80 (6.6%) | 1.198 (0.952, 1.508) | 0.128 |
Chronic Anticoagulant/ Antiplatelet Use | 8920 (18.6%) | 8725 (18.7%) | 195 (16%) | 0.83 (0.711, 0.969) | 0.019 |
Intravascular Thrombolytics | 11,040 (23.1%) | 10,810 (23.2%) | 230 (18.9%) | 0.774 (0.669–0.894) | 0.001 |
Patients with Stroke Location Identified | |||||
Posterior Circulation Stroke | 43,205 (90.3%) | 42,100 (90.3%) | 1105 (90.9%) | 1.079 (0.884–1.315) | 0.462 |
Anterior Circulation Stroke | 3160 (6.6%) | 3080 (6.6%) | 80 (6.6%) | 0.996 (0.792–1.254) | 1 |
Variables | Total Cohort Mean (St. Dv.) | Non-Blood Transfusion Mean (St. Dv.) | Blood Transfusion Mean (St. Dv.) | p-Value | |
Age | 68.86 (±14.839) | 68.85 (±14.841) | 69.35 (±14.789) | 0.240 | |
Elixhauser Comorbidity Index | 5.2785 (±1.88642) | 5.2554 (±1.87780) | 6.2646 (±2.00033) | <0.001 | |
NIHSS | 15.8003 (±7.60538) | 15.7706 (±7.61439) | 16.9383 (±7.16195) | <0.001 |
Variables | Total Cohort (47,835) | Non-Blood Transfusion (46,620, 97.5%) | Blood Transfusion (1215, 2.5%) | Blood Transfusion | |
---|---|---|---|---|---|
OR (CI 95%) | p-Value | ||||
DVT | 1750 (3.7%) | 1680 (3.6%) | 70 (5.8%) | 1.635 (1.279, 2.092) | <0.001 |
PE | 780 (1.6%) | 755 (1.6%) | 25 (2.1%) | 1.276 (0.853, 1.909) | 0.249 |
AKI | 6685 (14%) | 6340 (13.6%) | 345 (28.4%) | 2.519 (2.218, 2.862) | <0.001 |
Tracheostomy | 1095 (2.3%) | 975 (2.1%) | 120 (9.9%) | 5.13 (4.205, 6.259) | <0.001 |
Aphasia | 24,935 (52.1%) | 24,310 (52.1%) | 625 (51.4%) | 0.972 (0.867, 1.09) | 0.642 |
Hemiplegia | 39,180 (81.9%) | 38,160 (81.9%) | 1020 (84%) | 1.16 (0.993, 1.354) | 0.064 |
Herniation | 3455 (7.2%) | 3270 (7%) | 185 (15.2%) | 2.381 (2.028, 2.796) | <0.001 |
Coma | 13,400 (28%) | 13,050 (28%) | 350 (28.8%) | 1.041 (0.918, 1.18) | 0.539 |
Mechanical Ventilation | 6085 (12.7%) | 5755 (12.3%) | 330 (27.2%) | 2.648 (2.326, 3.014) | <0.001 |
Seizure | 2395 (5%) | 2355 (5.1%) | 40 (3.3%) | 0.64 (0.466, 0.879) | 0.006 |
Cerebral Edema | 9585 (20%) | 9250 (19.8%) | 335 (27.6%) | 1.538 (1.353, 1.748) | <0.001 |
Variables | Total Cohort (47,835) | Non-Blood Transfusion (46,620, 97.5%) | Blood Transfusion (1215, 2.5%) | Blood Transfusion | |||
---|---|---|---|---|---|---|---|
OR (CI 95%) | p-Value | ||||||
Prolonged Length of Stay > 6 Days | 20,525 (42.9%) | 19,660 (42.2%) | 865 (71.2%) | 3.389 (2.989–3.842) | <0.001 | ||
Routine Discharge | 10,210 (21.3%) | 10,105 (21.7%) | 105 (8.6%) | 0.342 (0.279–0.418) | <0.001 | ||
Home Health Care | 4565 (9.5%) | 4450 (9.5%) | 115 (9.5%) | 0.991 (0.816–1.203) | 0.961 | ||
Transfer to Short Term Hospital | 1540 (3.2%) | 1500 (3.2%) | 40 (3.3%) | 1.024 (0.744–1.409) | 0.934 | ||
Transfer to Skilled Nursing Facility | 26,220 (54.8%) | 25,510 (54.7%) | 710 (58.4%) | 1.163 (1.036–1.306) | 0.01 | ||
Leave Against Medical Advice | 130 (0.3%) | 130 (0.3%) | 0 (0%) | 0.997 (0.997–0.998) | 0.084 | ||
Inpatient Death | 40,745 (22%) | 38,055 (21.6%) | 2690 (30.1%) | 1.563 (1.492–1.638) | <0.001 | ||
Variables | Total Cohort Mean (St. Dv.) | Non-Blood Transfusion Mean (St. Dv.) | Blood Transfusion Mean (St. Dv.) | p-Value | |||
Length of Stay | 8.01 (±9.016) | 7.82 (±14.098) | 15.19 (±18.572) | <0.001 | |||
Total Charges | 193,262.15 (±158,504.767) | 190,477.39 (±153,188.438) | 302,633.31 (±279,289.332) | <0.001 |
Variables * | Inpatient Death | Routine Discharge | Prolonged Length of Stay > 6 Days | |||
---|---|---|---|---|---|---|
OR (CI 95%) | p-Value | OR (CI 95%) | p-Value | OR (CI 95%) | p-Value | |
Blood Transfusion | 1.96 (1.68–2.286) | <0.001 | 0.425 (0.342–0.527) | <0.001 | 2.928 (2.572–3.333) | <0.001 |
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Jain, A.; Aifuwa, E.; Bienenstock, R.; Kar, S.; Spirollari, E.; Sacknovitz, A.; Mashiach, E.; Koyfman, F.; Chong, J.; Medicherla, C.; et al. Outcomes of Blood Transfusions in Patients Undergoing Mechanical Thrombectomy for Acute Ischemic Stroke: A Population-Based Cross-Sectional Study of 47,835 Patients. Brain Sci. 2025, 15, 386. https://doi.org/10.3390/brainsci15040386
Jain A, Aifuwa E, Bienenstock R, Kar S, Spirollari E, Sacknovitz A, Mashiach E, Koyfman F, Chong J, Medicherla C, et al. Outcomes of Blood Transfusions in Patients Undergoing Mechanical Thrombectomy for Acute Ischemic Stroke: A Population-Based Cross-Sectional Study of 47,835 Patients. Brain Sciences. 2025; 15(4):386. https://doi.org/10.3390/brainsci15040386
Chicago/Turabian StyleJain, Ankita, Eseiwi Aifuwa, Raphael Bienenstock, Shayna Kar, Eris Spirollari, Ariel Sacknovitz, Elad Mashiach, Feliks Koyfman, Ji Chong, Chaitanya Medicherla, and et al. 2025. "Outcomes of Blood Transfusions in Patients Undergoing Mechanical Thrombectomy for Acute Ischemic Stroke: A Population-Based Cross-Sectional Study of 47,835 Patients" Brain Sciences 15, no. 4: 386. https://doi.org/10.3390/brainsci15040386
APA StyleJain, A., Aifuwa, E., Bienenstock, R., Kar, S., Spirollari, E., Sacknovitz, A., Mashiach, E., Koyfman, F., Chong, J., Medicherla, C., Gandhi, C. D., & Al-Mufti, F. (2025). Outcomes of Blood Transfusions in Patients Undergoing Mechanical Thrombectomy for Acute Ischemic Stroke: A Population-Based Cross-Sectional Study of 47,835 Patients. Brain Sciences, 15(4), 386. https://doi.org/10.3390/brainsci15040386