Abstract
Real-world data report worse 3-month clinical outcomes in elderly patients with acute ischemic stroke (AIS) treated with mechanical thrombectomy (MT). The aim was to identify factors influencing clinical outcome in elderly patients with anterior circulation AIS treated with MT (±intravenous thrombolysis (IVT)). In a retrospective, monocentric study, analysis of prospectively collected data of 138 patients (≥80 years) was performed. IVT was an independent negative predictor (OR 0.356; 95% CI: 0.134–0.942) and female sex an independent positive predictor (OR 4.179, 95% CI: 1.300–13.438) of 3-month good clinical outcome (modified Rankin scale 0–2). Female sex was also an independent negative predictor of 3-month mortality (OR 0.244, 95% CI: 0.100–0.599). Other independent negative predictors of 3-month good clinical outcome were older age, lower pre-stroke self-sufficiency, more severe neurological deficit and longer procedural intervals. Mortality was also independently predicted by longer procedural interval and by the occurrence of symptomatic intracerebral hemorrhage (p < 0.05 in all cases). Our results demonstrated, that in patients aged ≥80 years with anterior circulation AIS undergoing MT (±IVT), IVT reduced the chance of 3-month good clinical outcome and female sex was associated with a greater likelihood of 3-month good clinical outcome and lower probability of 3-month mortality.
Highlights
Mechanical thrombectomy (MT) is currently the standard treatment for acute ischemic stroke (AIS) in the anterior circulation due to the emergent large vessel occlusion (ELVO).MT has been shown to lead to higher recanalization rates and better clinical outcomes in selected patients compared to intravenous thrombolysis (IVT) alone [1,2,3,4,5]
The set consisted of 138 elderly patients (≥80 years) (98 females; mean age 84.6 ± 3.5 years), out of whom 57 (41.3%) patients were treated with MT alone (MT-A) and 81 (58.7%) patients with MT + IVT
The fact that AIS due to ELVO in elderly patients has a poor prognosis without MT supports the legitimacy of the use of MT in this age group, its results are significantly worse compared to younger patients despite similar successful recanalization rates [17,18,19,20,21,22,23,24]
Summary
Mechanical thrombectomy (MT) is currently the standard treatment for acute ischemic stroke (AIS) in the anterior circulation due to the emergent large vessel occlusion (ELVO). MT has been shown to lead to higher recanalization rates and better clinical outcomes in selected patients compared to intravenous thrombolysis (IVT) alone [1,2,3,4,5]. The factors influencing the clinical outcome in elderly patients have not been fully elucidated. The aim was to identify factors influencing the recanalization rate, the occurrence of symptomatic intracerebral hemorrhage (sICH) and the clinical outcome in elderly patients (≥80 years) with anterior circulation AIS due to ELVO undergoing MT (±IVT) in routine clinical practice Real-world data consistently report worse 3-month clinical outcomes in elderly patients compared to younger patients [17,18,19,20,21,22,23,24].
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
