Background

In-hospital ischaemic strokes are an uncommon but serious condition. Endovascular thrombectomy (EVT) is a therapeutic option for ischaemic strokes with large vessel occlusion.

Objective

In this paper we compare the functional and safety outcomes for patients undergoing EVT between stroke onset in hospital and stroke onset in community.

Methods

Using data from a national stroke registry, we used propensity score matched (PSM) individual level data of patients who underwent EVT, selected with stroke onset in hospital or onset in community, between (October 2015 and March 2020). Functional and safety outcomes were assessed for patients with in-hospital stroke and community-onset stroke.

Results

We included 4383 patients, stroke onset community 4133 (249 after PSM), stroke onset in hospital 250 (249 after PSM). Compared with stroke onset in community, patient with onset in hospital had similar mRS on discharge OR 0.99, 95% CI 0.73 to 1.35, p=0.963 and at 6 months OR 1.22, 95% CI 0.69 to 2.19, p=0.487 No significant difference in achieving good functional outcome (mRS ≤2 at discharge, OR 0.70, CI 0.36 to 1.36, p=0.29); successful reperfusion (modified Thrombolysis in Cerebral Infarction score of 2b-3) p=0.82; or safety outcomes of symptomatic intracranial haemorrhage (p=0.65) and in hospital mortality (p=0.25) were demonstrated.

Conclusions

EVT patients with in-hospital onset stroke have comparable functional and safety outcomes to patients with community onset stroke.