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

Background: Mechanical 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 evaluated predictors of very poor outcome at 3 months in older patients with stroke undergoing MT treatment.

Methods: We retrospectively collected data from consecutive stroke patients ≥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-month follow-up. Multiple logistic regression analysis was performed to identify the predictors of very poor outcome at 3 months.

Results: The study enrolled 62 patients with a median age of 85.5 years (interquartile range: 82.0-89.0). Of patients, 35 (56.5%) had a very poor outcome at 3-month follow-up. Multiple logistic regression analysis identified female sex (odds ratio = 3.592, 95% confidence interval 1.047-12.319, P = 0.042) and stroke-associated pneumonia (odds ratio = 6.103, 95% CI 1.541-24.174, P = 0.010) as independent predictors of very poor outcome.

Conclusions: In elderly stroke patients undergoing MT treatment, female sex and stroke-associated pneumonia were independent predictors of very poor outcome at 3 months.