Table 3.

Outcomes in IVT+EVT Cohort with Every 15-Minute Increment of Door-to-Needle Times

Door-to-Needle Time	≤30min (reference)	31–45min	46–60min	>60min	Per 15-min Increment*
90-day Home-Time (HT)
Median [Interquartile Range]	56 [1–81]	48 [0–77]	33 [0–74]	18 [0–69]
HT=0, never discharged to home within 90 days after acute stroke
Unadjusted OR (95% CI)		1.11 (0.92, 1.34)	1.32 (1.07, 1.61)	1.55 (1.25, 1.92)	1.12 (1.07, 1.17)
Adjusted OR (95% CI)		1.08 (0.88, 1.32)	1.19 (0.95, 1.50)	1.43 (1.11, 1.84)	1.10 (1.04, 1.16)
HT>0, per 1% (of 90 days) increase of home-time among those ever discharged to home
Unadjusted OR (95% CI)		0.91 (0.79, 1.04)	0.78 (0.67, 0.91)	0.71 (0.60, 0.83)	0.93 (0.90, 0.96)
Adjusted OR (95% CI)		1.00 (0.87, 1.14)	0.92 (0.79, 1.08)	0.79 (0.67, 0.94)	0.95 (0.92, 0.99)
1-year Home-Time
Median [Interquartile Range]	302 [8–352]	284 [4–349]	237 [2–344]	200 [0–340]
HT=0, never discharged to home within a year after acute stroke
Unadjusted OR (95% CI)		1.23 (1.00, 1.52)	1.43 (1.14, 1.80)	1.74 (1.37, 2.20)	1.13 (1.08, 1.19)
Adjusted OR (95% CI)		1.20 (0.95, 1.52)	1.29 (0.99, 1.67)	1.62 (1.22, 2.14)	1.12 (1.06, 1.19)
HT>0, per 1% (of 365 days) increase of home-time among those ever discharged to home
Unadjusted OR (95% CI)		0.96 (0.82, 1.13)	0.77 (0.64, 0.92)	0.68 (0.56, 0.83)	0.92 (0.88, 0.95)
Adjusted OR (95% CI)		1.03 (0.87, 1.22)	0.88 (0.72, 1.07)	0.72 (0.58, 0.90)	0.93 (0.89, 0.98)
1-year all-cause mortality
Unadjusted HR (95% CI)		1.01 (0.86, 1.20)	1.24 (1.04, 1.48)	1.34 (1.10, 1.63)	1.08 (1.04, 1.12)
Adjusted HR (95% CI)		0.99 (0.83, 1.20)	1.12 (0.92, 1.36)	1.32 (1.06, 1.65)	1.07 (1.02, 1.11)
1-year all-cause readmission †
Unadjusted HR (95% CI)		1.09 (0.95, 1.26)	1.16 (1.01, 1.33)	1.03 (0.89, 1.21)	1.02 (0.99, 1.06)
Adjusted HR (95% CI)		1.09 (0.94, 1.26)	1.05 (0.90, 1.23)	1.00 (0.83, 1.20)	1.01 (0.97, 1.05)

Abbreviations: IVT, intravenous thrombolytic therapy; EVT, endovascular thrombectomy; Ref: reference; OR, odds ratio; HR, hazard ratio; CI, confidence interval.

HT=0 refers to patients who either died or were unable to be discharged to home from acute hospital or post-acute care facility due to severe disability.

HT> 0 refers to those ever discharged to home. Median home-time were calculated among patients with HT>0.

The associations of DTN with home-time were estimated using a two-stage model, producing two odds ratios (ORs) for each DTN comparison. The ORs for “HT=0” indicated the ORs for having zero home-time in the longer DTN group compared with the shorter DTN group; values higher than one indicated that longer DTN was associated with higher odds of zero home days, an unfavorable outcome. The ORs for “home-time>0, 1% increase” indicated the ORs of a one percent (of 90 days or 365 days) increase in the proportion of home-time in the longer DTN group compared with the shorter DTN group among those who were discharged home; values lower than one indicated that longer DTN times were associated with lower odds of additional days spent at home, an unfavorable outcome.

Covariates for the adjusted models: (1) patient characteristics: age, sex, race-ethnicity, insurance, comorbidities (atrial fibrillation/flutter, previous stroke and transient ischemic attack, history of coronary artery disease/myocardial infarction, heart failure, carotid stenosis, diabetes mellitus, peripheral artery disease, hypertension, dyslipidemia, renal insufficiency, and smoking), antiplatelet or anticoagulant, onset-to-EVT times, admission systolic blood pressure, heart rate, glucose, and stroke severity as measured by the National Institutes of Health Stroke Scale (NIHSS); and (2) hospital characteristics: geographic region, urban/rural, total bed number, annual ischemic stroke volume, teaching status, and stroke center certification.

^*Door-to-Needle time was modeled as continuous variable.

^†Cause-specific model was used for readmission to account for competing risk of death.