Patients With Acute Ischemic Stroke Who Receive Brain Magnetic Resonance Imaging Demonstrate Favorable In-Hospital Outcomes

J Am Heart Assoc. 2020 Oct 20;9(20):e016987. doi: 10.1161/JAHA.120.016987. Epub 2020 Oct 10.

Abstract

Background Use of inpatient brain magnetic resonance imaging (MRI) in patients with acute ischemic stroke is highly institution dependent and has been associated with increased length and cost of hospital stay. We examined whether inpatient brain MRI in patients with acute ischemic stroke is associated with improved clinical outcomes to justify its resource requirements. Methods and Results The National Inpatient Sample database was queried retrospectively to find 94 003 patients who were admitted for acute ischemic stroke and then received inpatient brain MRI between 2012 and 2014. Multivariable regression analysis was performed with respect to a control group to assess for differences in the rates of inpatient mortality and complications, as well as the length and cost of hospital stay based on brain MRI use. Inpatient brain MRI was independently associated with lower rates of inpatient mortality (1.67% versus 3.09%; adjusted odds ratio [OR], 0.60; 95% CI, 0.53-0.68; P<0.001), gastrostomy (2.28% versus 2.89%; adjusted OR, 0.82; 95% CI, 0.73-0.93; P<0.001), and mechanical ventilation (1.97% versus 2.82%; adjusted OR, 0.68; 95% CI, 0.60-0.77; P<0.001). Brain MRI was independently associated with ≈0.32 days (8%) and $1131 (11%) increase in the total length (P<0.001) and cost (P<0.001) of hospital stay, respectively. Conclusions Inpatient brain MRI in patients with acute ischemic stroke is associated with substantial decrease in the rates of inpatient mortality and complications, at the expense of marginally increased length and cost of hospitalization.

Keywords: ischemic stroke; magnetic resonance imaging; outcomes research.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Correlation of Data
  • Costs and Cost Analysis
  • Female
  • Gastrostomy / statistics & numerical data
  • Hospital Mortality
  • Hospitalization* / economics
  • Hospitalization* / statistics & numerical data
  • Humans
  • Ischemic Stroke* / complications
  • Ischemic Stroke* / diagnostic imaging
  • Ischemic Stroke* / epidemiology
  • Ischemic Stroke* / therapy
  • Length of Stay / economics
  • Length of Stay / statistics & numerical data
  • Magnetic Resonance Imaging* / methods
  • Magnetic Resonance Imaging* / statistics & numerical data
  • Male
  • Neuroimaging* / methods
  • Neuroimaging* / statistics & numerical data
  • Respiration, Artificial / statistics & numerical data
  • United States / epidemiology