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Abstract Details

Central Retinal Artery Occlusion Patient Characteristics And Inpatient Management: Nationally Representative Data
Cerebrovascular Disease and Interventional Neurology
S52 - Acute Non-Interventional Stroke Care (4:14 PM-4:25 PM)
005
CRAO pathophysiology is thought to be similar to cerebral ischemic events.  However, nationally representative data is lacking on patient profiles and treatment, comparing CRAO and AIS.
Examine patient characteristics and inpatient treatment in central retinal artery occlusion (CRAO), compared to acute ischemic stroke (AIS) hospitalizations.
The National Readmissions Database contains data on ~50% of US hospitalizations in 2013-2015. We used validated International Classification of Diseases 9th Clinical Modification codes to identify index CRAO and AIS admissions, comorbidities, and procedures.  We used survey weighted methods to estimate nationally representative frequencies for categorical variables and means and SD for continuous variables, and compare frequencies and means by cohort (CRAO vs. AIS). 

There were 4871 CRAO and 1239963 AIS admissions; average age (66.8 years in CRAO, 70.8 years in AIS) and sex ratio (approximately 50%) were similar between groups.  CRAO patients were less likely (p<0.001) than AIS patients to have: diabetes (CRAO 24.3% vs AIS 36.8%); congestive heart failure (9.1% vs 14.8%); atrial fibrillation (15.5% vs 25.2%); hypertension (62.2% vs. 67.6%).   CRAO patients were more likely (p<0.001) to have valvular disease (13.3% vs 10.5%).  There were no group differences in hypercholesterolemia, depression, drug abuse, or chronic pulmonary disease.  CRAO admissions were shorter than AIS admissions (2.55 vs 6.8 days); more CRAO patients were discharged home (85.0% vs 40.2%) and had private insurance (23.6% vs 17.4%). IV thrombolysis was administered in 2.87% of CRAO cases; none received thrombectomy, 2.9% received biopsy of blood vessel and 0.66% received carotid endarterectomy. In the AIS cohort, 8.0% of cases received IV thrombolysis and 1.6% received thrombectomy.  

CRAO patients were less likely to have many comorbidities associated with AIS including DM, CHF, and atrial fibrillation, but more likely to have valvular disease. IV tPA was administered about 1/3 as often in CRAO cases. 
Authors/Disclosures
Emily Schorr, MD (UCSD)
PRESENTER
No disclosure on file
Kyle Rossi, MD (UMass Memorial Medical Center) No disclosure on file
Laura Stein, MD (Mount Sinai School of Medicine) The institution of Dr. Stein has received research support from American Heart Association.
Mandip S. Dhamoon, MD, MPH Dr. Dhamoon has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Faegre Baker Daniels LLP. Dr. Dhamoon has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Wellstar Health System Inc. Dr. Dhamoon has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Fabiani Cohen & Hall, LLP. Dr. Dhamoon has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for Kramer, Dillof, Livingston & Moore. Dr. Dhamoon has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Robins Kaplan. Dr. Dhamoon has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for Parker Waichman LLP. Dr. Dhamoon has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Heidell, Pittoni, Murphy & Bach, LLP.