Abstract DP160: Diagnostic Yield of Inpatient Pan-CT for Occult Malignancy in Ischemic Stroke: A Retrospective Analysis

Introduction: Pan-CT (chest, abdomen, pelvis) is used for malignancy screening in patients with AIS (acute ischemic stroke); however, its diagnostic yield in the inpatient setting has not been studied. In this retrospective analysis, we estimate yield of inpatient pan-CT for malignancy in AIS and describe its associated diagnostic pathways and effects on length-of-stay (LOS) and stroke management. This may guide patient selection and timing of pan-CT screening after AIS. We hypothesized inpatient pan-CT would increase LOS and would have low diagnostic yield. Methods: This was a single-center, retrospective, cross-sectional study (2020-2023). Patients were identified from billing data using ICD-10 code for AIS and concurrent CPT code for pan-CT performed for malignancy screen. We retrieved age, sex, LOS, imaging, and pathology results. We assessed the three-territory sign (TTS)–a proposed MRI marker for malignancy-related AIS, defined as infarcts in ≥3 vascular territories. Pan-CT results were categorized as positive, negative, or indeterminate for malignancy. Mann-Whitney test compared LOS between pan-CT categories. Chi-square test tested association between TTS and malignancy diagnosis. P