Uptake of AI for Large Vessel Occlusion Detection in Stroke Driven by Facility, Not Patient Factors

In Medicare strokes, AI adoption for LVOs tripled by 2022 but was driven by hospital type and geography, not patient demographics or severity. AI use was 21% in 2022, highest at comprehensive stroke centers (OR 1.5) and in the Stroke Belt (OR 2.0).

• Retrospective cohort of 2,116 inpatient ischemic stroke episodes from Medicare 5% files (2020–2023), all requiring thrombolytics.
• Adjusted odds of AI use peaked in 2022 (OR 6.0, 95% CI 2.7–13.3) and were higher at facilities with ≥1,000 beds.
• Limitations: Billing-code ascertainment of AI use; only captures NTAP-billed episodes, potentially underestimating true adoption.

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