Factors associated with prolonged intensive unit stay following mechanical thrombectomy for acute ischemic stroke

The aim of the study was to investigate factors affecting the length of stay (LoS) in the intensive care unit (ICU) following mechanical thrombectomy (MT) for acute ischemic stroke.

We conducted a retrospective analysis using data from a prospective stroke registry at a comprehensive stroke center between January 2019 and June 2024. ICU stay for more than 48 hours was defined as prolonged ICU stay.

Out of 808 patients, 39.2% (n = 317) required a prolonged ICU LoS. Prolonged ICU stay was more likely to have a baseline National Institutes of Health Stroke Scale NIHSS ≥ 15, higher mean HbA1c levels, posterior circulation stroke, intubation for the procedure, symptomatic intracerebral hemorrhage, in-patient mortality and ICU complications including pneumonia, deep vein thrombosis, pulmonary embolism, urinary tract infection (all p value < 0.05). Patients receiving thrombolysis prior to thrombectomy were less likely to have a prolonged LoS (p = 0.0025). Independent predictors for prolonged ICU LoS included baseline NIHSS ≥ 15 (odds ratio [OR] 1.83, p = 0.0004), intubation prior to the procedure (OR 2.20, p < 0.0001), receiving IV thrombolysis (OR 0.66, p = 0.0144), recanalization (OR 0.48, p = 0.0085, composite ICU complications (OR 2.66, p < 0.0001), and symptomatic intracranial hemorrhage (sICH) (OR 3.38, p < 0.0001).

Almost one-third of the acute ischemic stroke patients required a prolonged LoS following MT. A better understanding of the factors associated with prolonged ICU stay may assist in appropriate allocation of resources.