Higher Patient Volumes for Stroke Centers Correlates with Improved Mechanical Thrombectomy Outcomes

  • Clot retrieval
  • Ischemic stroke
  • Mechanical thrombectomy
  • Stroke
  • Stroke outcomes

As published in the journal Stroke, data from the 24 sites in the TRACK study (NCT02040259) show that medium-to-high treatment volume correlates with improved outcomes of mechanical thrombectomy. Each site in the study was identified as low- (< 2 cases/month), medium- (2-4 cases/month), or high-volume (> 4 cases/month).

Baseline features, imaging, and outcomes were collected for 624 individuals treated. Of those treated, 188 (30.1%) had care at low-volume centers, 175 (28.1%) and 261 (41.8%) at high- volume centers. Time to treatment, length of procedure, use of balloon catheters, and outcomes varied significantly amongst the 3 groups (Table). After multivariable adjustment, those treated in the high- or medium volume centers were 67% to 75% more likely to have a good outcome compared with those treated in low-volume centers (P = .04 and .03, respectively). Outcomes in medium- vs high-volume centers did not differ significantly. 
The baseline NIHSS score was 16.8 to 17.6, which also was not significantly different across groups. Occlusion sites did not vary significantly amongst the 3 groups and the mean age of individuals treated was 65 to 67 with no significant difference age across the groups. No significant differences in intracranial hemorrhage or 90-day mortality was seen across the 3 groups.

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