2018 was a big year for changes in acute ischemic stroke care. In January, the AHA/ASA updated its guidelines for the early management of acute ischemic stroke (AIS) patients, most notably expanding patient eligibility for IV-tPA and quadrupling the time window for mechanical thrombectomy. In March, the Joint Commission/AHA/ASA awarded the first Thrombectomy-Capable Stroke Center (TSC) certification to St. Joseph Mercy Oakland in Pontiac, Michigan.
After receiving numerous questions from hospitals about how they should adjust their stroke program strategy to the new guidelines and certification option, Advisory Board looked into trends in AIS care volumes. In particular, we wanted to learn how “medical” volumes (DRGS 61-63) compared to “interventional” volumes (DRGs 20-27, 31-33). Due to the guideline changes, many hospitals expected a substantial increase in total AIS volumes; and that the increase would be specifically concentrated in mechanical thrombectomy (interventional) volumes.