Comparison Between In‐Hospital and Community‐Onset Stroke Treated With Endovascular Thrombectomy: A Propensity Score–Matched Cohort Study

Background Patients with acute ischemic stroke onset during hospital admission often have concurrent illnesses, increased underlying comorbidities and are associated a delayed recognition of onset, compared patients in the community (community‐onset [COS]). Endovascular thrombectomy (EVT) for large‐vessel occlusion has been proven to be effective, though safety feasibility EVT among in‐hospital (IHS) remains undetermined. We aim compare workflow clinical outcomes undergoing following IHS COS. Methods Using data from national registry, we used propensity score‐matched individual‐level who underwent EVT, COS, between October 2015 March 2020. Univariate analysis was performed assess procedural, functional, outcomes. Results included 4353 (COS, 4104 [249 after score matching]; IHS, 249 matching]). Compared had similar modified Rankin Scale on discharge (odds ratio [OR], 0.98 [95% CI, 0.72–1.34]; P =0.96) at 6 months (OR, 1.25 0.71–2.24]; =0.48). No significant difference achieving good functional outcome (modified ≤ 2 discharge; 31.3% [IHS] versus 29.3% [COS]; OR,=1.10 CI 0.74–1.60]; =0.61), successful reperfusion Thrombolysis Cerebral Infarction 2b–3), =0.82; or symptomatic intracranial hemorrhage ( =0.64) mortality =0.26) were demonstrated. Shorter time interval imaging group (IHS, 80±88 216±292 minutes) observed. The imaging‐to‐arterial‐puncture not significantly different groups 160±140 162±184 minutes; =0.85). Conclusions is safe feasible, comparable this registry. Continued efforts required improve inpatient recognizing symptoms initiating treatment eligible IHS.