Data from: Endovascular treatment in older adults with acute ischemic stroke in the MR CLEAN Registry
Coutinho, Jonathan M. et al. (2021), Data from: Endovascular treatment in older adults with acute ischemic stroke in the MR CLEAN Registry, Dryad, Dataset, https://doi.org/10.5061/dryad.hx3ffbg98
Objective: To explore clinical outcomes in older adults with acute ischemic stroke treated with endovascular thrombectomy (EVT).
Methods: We included consecutive patients (2014–2016) with an anterior circulation occlusion undergoing EVT from the MR CLEAN Registry. We assessed the effect of age (dichotomized at ≥80 years, and as continuous variable) on the modified Rankin Scale [mRS] score at 90 days, symptomatic intracranial hemorrhage (sICH), and reperfusion rate. The association between age and mRS was assessed with multivariable ordinal logistic regression, and a multiplicative interaction term was added to the model to assess modification of reperfusion by age on outcome.
Results: 380/1526 (25%) of patients were 80 years or older (=older adults). Older adults had a worse functional outcome than younger patients (adjusted common OR for an mRS shift towards better outcome: 0.31, 95%CI 0.24–0.39). Mortality was also higher in older adults (51% vs. 22%, aOR 3.12, 95%CI 2.33–4.19). There were no differences in proportion of patients with mRS 4-5, sICH, or reperfusion rates. Successful reperfusion was more strongly associated with a shift towards good functional outcome in older adults than in younger patients (acOR 3.22, 95%CI 2.04–5.10 vs. 2.00, 95%CI 1.56–2.57, Pinteraction=0.026).
Conclusion: Older age is associated with an increased absolute risk of poor clinical outcome, while the relative benefit of successful reperfusion seems to be higher in these patients. These results should be taken into consideration when selecting older adults for EVT.