Recent Nationwide Trends in Transcranial Doppler Utilization During Acute Ischemic Stroke Hospitalizations (P4.296)

Objective: To characterize recent trends in the utilization of Transcranial Doppler(TCD) for patients hospitalized with acute ischemic stroke(AIS) in the United States. Background: As endovascular therapy for AIS expands and patients transfer to comprehensive stroke centers grows, the need for quick assessment of the cervicocephalic arterial tree is important. TCD is portable and inexpensive as compared to CT/MR angiograms. However, it is unclear how frequently and under what circumstances TCD has recently been used during AIS hospitalizations. Evaluating patterns of TCD use during AIS hospitalizations may identify opportunities for improvement in its utilization. Design/Methods: Data on adult patients (≥18 yr) in the Nationwide Inpatient Sample were analyzed from the year 2000 to 2011. Primary discharge diagnoses of AIS were identified using the(ICD-9-CM) diagnosis codes 433–436 and 437.1. ICD-9 Procedure 88.71 was coded as diagnostic ultrasound of head(TCD). We assessed utilization of TCD by Cochran-Armitage trend test as well as predictors of TCD use by multivariable survey logistic regression. A multivariable linear regression model was used to compute the cost of stroke hospitalizations associated with TCD. Results: Of 5,223,361 patients identified with a primary diagnosis of AIS, 146,033(2.8%) had TCD examination. There was significant decline in utilization of TCD every year(4.86% in 2000 to 1.92% in 2011, p Conclusions: Over the last decade there has been a slight but steady decrease in the use of TCD during AIS hospitalizations in the US. Future studies should examine the cost-utility of TCD, especially with the advent of endovascular stroke treatment systems. Disclosure: Dr. Liu has nothing to disclose. Dr. Lunagariya has nothing to disclose. Dr. Patel has nothing to disclose. Dr. Patel has nothing to disclose. Dr. Feng has nothing to disclose. Dr. Ovbiagele has nothing to disclose.