Endovascular treatment in older adults with acute ischemic stroke in the MR CLEAN Registry

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)....