Sarcopenia and ischemic stroke outcomes after endovascular revascularization: results of a retrospective, cohort...

Stroke is a major cause of disability and mortality, with its incidence increasing with age. Despite advances in acute stroke treatment, functional outcomes in elderly patients are not always as favorable as expected. Therefore, additional efforts are required to identify reliable prognostic markers and improve patient outcomes. Sarcopenia has been recognized as a negative factor influencing functional outcomes after ischemic stroke. Temporalis muscle thickness (TMT), assessed on routine imaging, has emerged as a potential surrogate marker for sarcopenia; however, its prognostic value in stroke patients has not yet been conclusively established. This study aimed to evaluate the association between TMT and functional outcome, assessed using the modified Rankin Scale (mRS) at hospital discharge, and in-hospital death. In this retrospective cohort study, we included 152 consecutive patients (median age, 74 years [IQR, 63-83]; 53% male) admitted to the Department of Neurology at the University of Medicine Rostock who underwent endovascular revascularization (EVT) for acute ischemic stroke. TMT was determined from initial cranial CT scans. Due to the small sample size, we used a uniform TMT cutoff value (5.78 mm) for sarcopenia. The primary endpoint was the mRS at discharge. Sarcopenic patients were older (p < 0.001), more often female (p < 0.001), and had a lower BMI (p = 0.045). They also had significantly worse functional outcomes (p = 0.006) and higher comorbidity burdens (atrial fibrillation, p = 0.023; arterial hypertension, p = 0.024; smoking, p = 0.020). Poor outcome was significantly associated with sarcopenia, but this association lost significance after adjustment. In the group comparison regarding mortality, deceased patients had lower TMT and were more frequently sarcopenic. However, these associations also lost significance in the multivariate model.