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Introduction Cerebral venous thrombosis (CVT) is an uncommon form of stroke with relatively low mortality but higher incidence in younger adults.1–3 Previous work has suggested decreased overall stroke hospitalization volumes, but preserved CVT hospitalization volumes and increased CVT mortality during the COVID‐19 pandemic.4,5 We sought to provide updated incidence and trend data for cerebral venous thrombosis (CVT) in the United States from 2016‐2020, examine the impact of the COVID‐19 pandemic on CVT, and identify predictors of in‐hospital mortality. Methods Validated ICD‐10 codes were used to identify patients with CVT in the National Inpatient Sample (NIS) between 2016 and 2020. The NIS is part of the Healthcare Cost and Utilization Project (HCUP) and is maintained the Agency for Healthcare Research and Quality. The NIS provides a stratified nationally representative 20% sample of all hospital discharges in the United States, excluding rehabilitation and long‐term acute care hospitals. Annual updates to the NIS are released approximately 20 months after the conclusion of the data year. Sample weights were applied to generate nationally representative estimates, and census data were used to compute incidence rates. The first wave of the COVID‐19 pandemic was defined as January‐May 2020. Predictor variables for mortality were selected based upon previous studies of incidence and outcomes of CVT and biological plausibility.6–8 Multivariable logistic regression was conducted using all predictor variables that achieved p

Introduction Large vessel occlusion (LVO) and dehydration are both independently associated with poor functional outcomes and increased odds of mortality in acute ischemic stroke. Dehydration has previously been shown to affect collateral blood flow in LVO stroke, but it is unclear if this leads to worsened clinical outcomes. Methods A stroke center registry (10/2019‐12/2021) of consecutive adults who had undergone successful endovascular therapy (EVT, with thrombolysis in cerebral infarction score 2b/3) for anterior circulation LVO (ICA, M1, or M2) was queried. Dehydration on presentation was defined using laboratory surrogates: blood urea nitrogen/creatinine ratio >15 or serum osmolality >296 mOsm/kg. The primary outcome was a favorable shift in 90‐day modified Rankin Scale (mRS) using a proportional odds model, adjusting for age, pre‐stroke mRS, National Institutes of Health Stroke Scale (NIHSS), and Alberta Stroke Program Early Computed Tomography Scale (ASPECTS). Secondary outcomes included early improvement in 24h NIHSS. Results Of the 318 patients with anterior LVO who underwent EVT, 206 (65%) met criteria for dehydration, and 181 (87.9%) had both mRS and ASPECTS data available. Younger age, lower NIHSS, lower mRS, and higher ASPECTS were all strongly and independently associated with a favorable shift in 90d mRS. Dehydrated patients had similar changes in 24‐hr NIHSS scores (‐5 [interquartile range, IQR ‐10 to 0] vs. ‐5 [IQR ‐8 to 0], p = 0.37). Dehydration was not associated with a less favorable shift in 90‐day mRS (odds ratio [OR] 0.74, 95% confidence interval [CI] 0.41‐1.33), which remained non‐significant after multivariable adjustment (OR 1.46, 95%CI 0.74‐2.86). With serum osmolality assessed continuously, higher serum osm was associated with a less favorable shift in mRS at 90d (OR 0.95, 95%CI 0.92‐0.99, p = 0.009), but this did not persist after multivariable adjustment (p = 0.92) and was driven by the association between higher osmolality and age (r = 0.24, p(bonferroni)< 0.01) and pre‐stroke mRS (r = 0.20, p(bonferroni) = 0.04). Conclusions There was no association between dehydration and lower odds of early clinical improvement or long‐term functional recovery following successful endovascular thrombectomy.