Abstract W P162: Utilization of Vascular Imaging in Stroke: A Population Based Study
Introduction: Rates of diagnostic workup in stroke have increased over time. However less is known about utilization of vascular imaging for stroke from a population perspective. We sought to evaluate the utilization and predictors of vascular imaging modalities in years 2005 and 2010 in a population-based study.
Methods: Stroke and TIA patients were identified in a metropolitan population of 1.3 million served by 15 different inpatient hospitals in the Greater Cincinnati area in the calendar years of 2005 and 2010. Patient charts and imaging records were abstracted by research nurses and reviewed by study physicians. The proportion of vascular imaging use including CT angiogram (CTA), MR angiogram (MRA), digital subtraction angiogram (DSA) and carotid ultrasound was computed. Multivariate logistic regression modeling for the following variables was performed: age, race, gender, and insurance, NIHSS, ED presentation and hospital type.
Results: In 2005, there were 3558 stroke/TIA events with imaging data available in 3307 patients and, in 2010; there were 3597 stroke/TIA events with imaging data in 3374 patients. Overall, vascular imaging has increased from 72% in 2005 to 77% in 2010 (p-value <0.001). Specifically, use of CTA increased from 2% in 2005 to 11% in 2010 (p-value <0.001), MRA decreased from 38% to 37%, ultrasound increased from 48% to 53% (p <0.001) and DSA decreased from 6% to 3% (p-value <0.001) (table). In the combined study periods, 22% of 7115 events had multiple vascular imaging studies. Younger age, ischemic stroke subtype, ED and academic hospital were associated with increased vascular imaging use.
Conclusion: Vascular imaging, particularly noninvasive studies showed increase over time, with CTA studies demonstrating the maximum increase in this population-based study.
Author Disclosures: A. Vagal: Research Grant; Significant; American Roentgen Ray Society Scholarship Grant. H. Sucharew: Research Grant; Significant; NIH. K. Alwell: Research Grant; Significant; NIH. J. Khoury: Research Grant; Significant; NIH. P. Khatri: Honoraria; Modest; Academic Grand Rounds (paid to Dept). Other; Modest; Taylor and Francis-Stroke Ctr Handbook book royalties (paid to Dept). Research Grant; Significant; NIH/NINDS (IMS III, NSTN NCC/RCC). Other Research Support; Significant; Significant; Genentech-PRISMS Trial PI (paid to Dept), Penumbra-THERAPY Trial PI (paid to Dept). D. Woo: Research Grant; Modest; NS30678. M. Flaherty: Research Grant; Significant; NIH. B. Kissela: Research Grant; Significant; NIH. O. Adeoye: Research Grant; Significant; NIH/NINDS. S. Ferioli: Research Grant; Modest; NS30678. F. De Los Rios La Rosa: None. S. Martini: Research Grant; Modest; NS30678. J. Mackey: None. D. Kleindorfer: Research Grant; Significant; NIH. Speakers' Bureau; Modest; Genentech. Expert Witness; Modest; Expert witness. Consultant/Advisory Board; Modest; Genentech.
- © 2014 by American Heart Association, Inc.