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General Anesthesia and Increased Stroke Fatality
Stroke; ePub 2017 Jan 9; Bekelis, Missios, et al
Using a comprehensive all-payer cohort of acute ischemic stroke patients undergoing mechanical thrombectomy in New York State, researchers recently identified an association of general anesthesia with increased case-fatality and length of stay. These considerations should be taken into account when standardizing acute stroke care. A cohort study was performed involving patients undergoing mechanical thrombectomy for ischemic stroke from 2009 to 2013, who were registered in the New York Statewide Planning and Research Cooperative System database. They found:
- Among 1,174 patients, 441 (37.6%) underwent general anesthesia and 733 (62.4%) underwent conscious sedation.
- Using an instrumental variable analysis, general anesthesia was associated with a 6.4% increased case-fatality and 8.4 days longer length of stay in comparison to conscious sedation.
- This corresponded to 15 patients needing to be treated with conscious sedation to prevent 1 death.
Bekelis K, Missios S, MacKenzie TA, Tjoumakaris S, Jabbour P. Anesthesia technique and outcomes of mechanical thrombectomy in patients with acute ischemic stroke. [Published online ahead of print January 9, 2017]. Stroke. doi:10.1161/STROKEAHA.116.015343.