NYMC Faculty Publications

Obstructive Sleep Apnea Confers Lower Mortality Risk in Acute Ischemic Stroke Patients Treated With Endovascular Thrombectomy: National Inpatient Sample Analysis 2010-2018

Justin M. Lapow, New York Medical College School of Medicine, Valhalla, New York, USA.
Alis J. Dicpinigaitis, New York Medical College School of Medicine, Valhalla, New York, USA.
Rajkumar S. Pammal, New York Medical College School of Medicine, Valhalla, New York, USA.
Griffin A. Coghill, New York Medical College School of Medicine, Valhalla, New York, USA.
Osher Rechester, Westchester Medical Center, Valhalla, New York, USA.
Eric Feldstein, Neurosurgery, New York Medical College Department of Neurosurgery, Valhalla, New York, USA.
Rolla Nuoman, Neurology, Westchester Medical Center, Valhalla, New York, USA.
Kristina Maselli, Westchester Medical Center, Valhalla, New York, USA.
Shyla Kodi, New York Medical College School of Medicine, Valhalla, New York, USA.Follow
Andrew Bauerschmidt, Neurology and Neurosurgery, Westchester Medical Center, Valhalla, New York, USA.Follow
Jon B. Rosenberg, Neurology and Neurosurgery, Westchester Medical Center, Valhalla, New York, USA.
Shadi Yaghi, Department of Neurology, Brown University, Providence, Rhode Island, USA.
Gurmeen Kaur, Neurosurgery, Westchester Medical Center, Valhalla, New York, USA.
Christeen Kurian, Neurology, Westchester Medical Center, Valhalla, New York, USA.
Ji Y. Chong, Neurology, Westchester Medical Center, Valhalla, New York, USA.Follow
Stephan A. Mayer, Neurology, Westchester Medical Center, Valhalla, New York, USA.Follow
Chirag D. Gandhi, Neurosurgery, Westchester Medical Center, Valhalla, New York, USA.Follow
Fawaz Al-Mufti, Neurology and Neurosurgery, Westchester Medical Center, Valhalla, New York, USA fawaz.al-mufti@wmchealth.org.Follow

Author Type(s)

Faculty, Resident/Fellow

DOI

10.1136/neurintsurg-2021-018161

Journal Title

Journal of Neurointerventional Surgery

First Page

1195

Last Page

1199

Document Type

Article

Publication Date

12-1-2022

Department

Neurology

Second Department

Pediatrics

Third Department

Neurosurgery

Abstract

UNLABELLED: BackgroundObstructive sleep apnea (OSA) portends increased morbidity and mortality following acute ischemic stroke (AIS). Evaluation of OSA in the setting of AIS treated with endovascular mechanical thrombectomy (MT) has not yet been evaluated in the literature. METHODS: The National Inpatient Sample from 2010 to 2018 was utilized to identify adult AIS patients treated with MT. Those with and without OSA were compared for clinical characteristics, complications, and discharge disposition. Multivariable logistic regression analysis and propensity score adjustment (PA) were employed to evaluate independent associations between OSA and clinical outcome. RESULTS: Among 101 093 AIS patients treated with MT, 6412 (6%) had OSA. Those without OSA were older (68.5 vs 65.6 years old, p<0.001), female (50.5% vs 33.5%, p<0.001), and non-caucasian (29.7% vs 23.7%, p<0.001). The OSA group had significantly higher rates of obesity (41.4% vs 10.5%, p<0.001), atrial fibrillation (47.1% vs 42.2%, p=0.001), hypertension (87.4% vs 78.5%, p<0.001), and diabetes mellitus (41.2% vs 26.9%, p<0.001). OSA patients treated with MT demonstrated lower rates of intracranial hemorrhage (19.1% vs 21.8%, p=0.017), treatment of hydrocephalus (0.3% vs 1.1%, p=0.009), and in-hospital mortality (9.7% vs 13.5%, p<0.001). OSA was independently associated with lower rate of in-hospital mortality (aOR 0.76, 95% CI 0.69 to 0.83; p<0.001), intracranial hemorrhage (aOR 0.88, 95% CI 0.83 to 0.95; p<0.001), and hydrocephalus (aOR 0.51, 95% CI 0.37 to 0.71; p<0.001). Results were confirmed by PA. CONCLUSIONS: Our findings suggest that MT is a viable and safe treatment option for AIS patients with OSA.

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