Observational studyStroke2025
Hospital Implementation of Endovascular Thrombectomy and Health Equity in Acute Stroke Outcomes.
Observational study in Stroke, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
12 authors.
Funding
Abstract
backgroundThe introduction of novel therapeutics into clinical practice could impact equity in health outcomes.
methodsThis was a retrospective, observational cohort study based on the Get With The Guidelines-Stroke program of the American Heart Association. Two epochs were considered: January 2010 to December 2014 and January 2016 to December 2019. The primary exposure was the availability of endovascular thrombectomy (EVT) at the hospital level defined by the degree of implementation of EVT (>10% change from pre-2015 to post-2015) after balancing key patient and hospital characteristics with overlap weighting. The coprimary end points were (1) the difference in in-hospital mortality for patients from counties with median income >$60 000 versus <$60 000 and (2) the difference in in-hospital mortality between Black and White patients. Secondary end points were differences in in-hospital mortality by sex, insurance status, county-level poverty, and county-level educational attainment. Exploratory end points were differences in ambulatory status at hospital discharge and a composite of in-hospital mortality/discharge to hospice across the above categories.
resultsOf 173 049 patients (median age, 75 years; 53.9% female) potentially eligible for EVT, 39 196 (22.7%) received EVT (7572 [10.0% of potentially eligible patients] between 2010 and 2014 and 31 624 [32.6% of potentially eligible patients] between 2016 and 2019). From 2010 to 2014, 1565 (20.7%) of patients and from 2016 to 2019, 5158 (16.3%) who received EVT died in hospital. Implementation of EVT was associated with decreased disparities in mortality rates for patients from counties with median inflation-adjusted income >$60 000 versus <$60 000 (absolute risk difference, 3.9% [95% CI, 0.53%-7.3%]). Implementation of EVT was not associated with changes in differences in in-hospital mortality by race, sex, county poverty rates, county educational attainment, or insurance status.
conclusionsAmong patients with acute ischemic stroke who were potentially eligible for EVT, the implementation of EVT on a hospital level did not worsen health equity in any dimension (race/ethnicity, sex, or insurance status) and was associated with improvements in socioeconomic equity in acute ischemic stroke mortality.
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