Long-term functional outcomes for elderly patients treated with endovascular thrombectomy

Area of Science:

• Neurology
• Geriatrics
• Interventional Cardiology

Background:

• Functional outcomes for elderly thrombectomy patients are typically reported up to 90 days.
• Long-term neurological status in this demographic remains less characterized.
• This study focuses on 1-year outcomes in patients aged 80 and older.

Purpose of the Study:

• To evaluate 1-year functional outcomes in patients aged 80 and older undergoing thrombectomy.
• To identify predictors of functional independence in elderly thrombectomy patients.
• To compare outcomes between elderly (≥80 years) and younger (<80 years) thrombectomy patients.

Main Methods:

• Retrospective analysis of anterior circulation thrombectomy patients from November 2016 to August 2023.
• Primary outcome: 1-year modified Rankin Scale (mRS) score of 0-2 (functional independence).
• Logistic regression used to identify predictors of 1-year functional independence in the elderly cohort.

Main Results:

• 957 patients included; 220 (23%) were ≥80 years old.
• Significantly lower functional independence at 1 year in the elderly group (18.6%) compared to younger patients (45.9%).
• Predictors of independence in the elderly: younger age, lower premorbid mRS, lower NIH Stroke Scale score, higher cerebral blood volume index, and first-pass recanalization.

Conclusions:

• Elderly thrombectomy patients demonstrate reduced rates of 1-year functional independence.
• These rates are comparable to previously reported 90-day outcomes in octogenarians and nonagenarians.
• Factors like collateral status and single-pass revascularization are important prognostic indicators beyond 90 days for elderly patients.