Background: We quantified the effect of nationwide contrast media shortage, initiated on April 19 th , 2002 after GE Healthcare rationing, on evaluation of acute ischemic stroke (AIS) patients. Methods: We analyzed the data on 41,926 AIS patients (46,157 studies) who underwent imaging processed with Viz.ai software at 185 hospitals in the United States from Feb 28, 2022 through July 11, 2022. We quantified the overall (and in various strata) percentage change in daily number of computed tomographic angiography (CTA) and perfusions (CTP) performed, and the change in proportion of patients with large arterial occlusion (LVO) identified and image quality (CTP quality warnings) before and after April 19 th . Results: The daily counts of unique patients who underwent CTA decreased (a 14% reduction) in April: from 2.099 studies (before April 19 th ) to 1.811 studies (after April 19 th ) per day per hospital (see Figure). The reduction was most prominent in comprehensive stroke centers and in sites that used GE contrast media (24% versus 12%). There was no change in the proportions of patients with LVO identified (8.69% versus 9.34%) and inadequate tests (5.86% versus 5.00%). Conclusions: There was a prominent reduction in CTA performed in the United States due to contrast media shortage. However, the proportion of patients with LVO identified was not affected.
BACKGROUND AND PURPOSE:We performed this study to identify the effect of the nationwide iodinated contrast media shortage due to reduction in GE Healthcare production, initiated on April 19, 2022, on the evaluation of patients with stroke. MATERIALS AND METHODS:We analyzed the data on 72,514 patients who underwent imaging processed with commercial software in a sample of 399 hospitals in United States from February 28, 2022, through July 10, 2022. We quantified the percentage change in the daily number of CTAs and CTPs performed before and after April 19, 2022. RESULTS:The daily counts of individual patients who underwent CTAs decreased (a 9.6% reduction, P ¼ .002) from 1.584 studies per day per hospital to 1.433 studies per day per hospital. The daily counts of individual patients who underwent CTPs decreased (a 25.9% reduction, P ¼ .003) from 0.484 studies per day per hospital to 0.358 studies per day per hospital. A significant reduction in CTPs using GE Healthcare contrast media (43.06%, P , .001) was seen but not in CTPs using non-GE Healthcare contrast media (increase by 2.93%, P ¼ .29). The daily counts of individual patients with large-vessel occlusion decreased (a 7.69% reduction) from 0.124 per day per hospital to 0.114 per day per hospital.CONCLUSIONS: Our analysis reported changes in the use of CTA and CTP in patients with acute ischemic stroke during the contrast media shortage. Further research needs to identify effective strategies to reduce the reliance on contrast media-based studies such as CTA and CTP without compromising patient outcomes.
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