Predictors of Very Poor Outcome After Mechanical Thrombectomy in Older Patients with Acute Ischemic Stroke

Abstract

BackgroundMechanical thrombectomy (MT) is an effective treatment for patients with acute ischemic stroke due to large vessel occlusion. However, some elderly patients with recanalization have a very poor outcome, including vegetative state and mortality. This study aimed to evaluate the predictors for very poor outcome at 3 months in older stroke patients undergoing MT treatment. MethodsWe retrospectively collected data from consecutive stroke patients over 80 years old undergoing MT between April 2018 and January 2021. A very poor outcome was defined as a modified Rankin Scale (mRS) score of 5 or 6 at 3-months of follow-up. Multiple logistic regression analysis was performed to identify the predictors of very poor outcome at 3 months. ResultsA total of 62 patients were enrolled and the median age were 85.5 (82.0-89.0) years old. Among them, 35 (56.5%) patients had a very poor outcome at 3 months of follow-up. Multiple analysis identified female (OR=3.592, 95% CI: 1.047-12.319, p=0.042) and stroke-associated pneumonia (OR=6.103, 95% CI: 1.541-24.174, p=0.010) as independent predictors of very poor outcome. ConclusionWe followed up the prognosis of elderly stroke patients undergoing MT treatment and found female and more stroke-associated pneumonia were independent predictors for very poor outcome at 3 months.