Factors associated with prolonged intensive unit stay following mechanical thrombectomy for acute ischemic stroke.

Abstract

Objective and background: The aim of the study was to investigate factors affecting the length of stay (LoS) in the intensive care unit (ICU) following mechanical thrombectomy (MT) for acute ischemic stroke.

Methods: We conducted a retrospective analysis using data from a prospective stroke registry at a comprehensive stroke center between January 2019 and June 2024. ICU stay for more than 48 hours was defined as prolonged ICU stay.

Results: Out of 808 patients, 39.2% (n = 317) required a prolonged ICU LoS. Prolonged ICU stay was more likely to have a baseline National Institutes of Health Stroke Scale NIHSS ≥ 15, higher mean HbA1c levels, posterior circulation stroke, intubation for the procedure, symptomatic intracerebral hemorrhage, in-patient mortality and ICU complications including pneumonia, deep vein thrombosis, pulmonary embolism, urinary tract infection (all p value < 0.05). Patients receiving thrombolysis prior to thrombectomy were less likely to have a prolonged LoS (p = 0.0025). Independent predictors for prolonged ICU LoS included baseline NIHSS ≥ 15 (odds ratio [OR] 1.83, p = 0.0004), intubation prior to the procedure (OR 2.20, p < 0.0001), receiving IV thrombolysis (OR 0.66, p = 0.0144), recanalization (OR 0.48, p = 0.0085, composite ICU complications (OR 2.66, p < 0.0001), and symptomatic intracranial hemorrhage (sICH) (OR 3.38, p < 0.0001).

Conclusions: Almost one-third of the acute ischemic stroke patients required a prolonged LoS following MT. A better understanding of the factors associated with prolonged ICU stay may assist in appropriate allocation of resources.