Abstract WP432: Availability of Biplane Angiographic Units Within Hospitals and Outcomes of Patients with Ischemic Stroke or Subarachnoid Hemorrhage-Results of a State Wide Study
Background: The Brain Attack Coalition identified the availability of neuro-endovascular procedures as an essential component of a comprehensive stroke center. However, there is minimal data regarding availability of angiographic suites within hospitals in a population based study.
Methods: Statewide estimates of stroke admissions and outcomes, cervicocerebral angiograms, thrombolysis, endovascular ischemic stroke treatments, carotid angioplasty and stent placement or endarterectomy, intracranial angioplasty and stent placements, and endovascular or surgical treatment of intracranial aneurysms per hospital based on availability of monoplane or biplane angiographic suites were obtained. The availability was determined by database of any diagnostic x-ray system installation mandated under Subchapter C - Electronic Product Radiation Control of Food and Drug Administration.
Results: A total of 15699 (13 hospitals), 16540 (9 hospitals), and 15321(114 hospitals) ischemic stroke patients were admitted to hospitals with monoplane, biplane, and no angiographic suites, respectively. The rate of any thrombolysis (p<0.001) and thrombectomy (p<0.001) was significantly lower in hospitals without any angiographic suites. The rate of none-to-minimal disability was significantly lower among patients in hospitals without angiographic suites (52% versus 65% and 66%, p<0.001). Of the subarachnoid hemorrhage patients, 722, 1006, and 296 were admitted to hospitals with monoplane, biplane, and no angiographic suites, respectively. The rate of both surgical (p<0.001) and endovascular (p<0.001) treatments for intracranial aneurysms was significantly higher among hospitals with biplane angiographic suite. The in- hospital mortality was significantly lower among patients treated at hospitals with biplane angiographic suite (13%) versus those treated at facilities with monoplane (24%) and no angiographic suites (27%, p<0.001).
Conclusions: Availability of biplane angiographic units within hospitals was associated with better outcomes and lower mortality in patients with ischemic stroke or subarachnoid hemorrhage. However, a large proportion of such patients continue to be admitted to hospitals without such capabilities.
- © 2012 by American Heart Association, Inc.