ArticleBMJ open2014
Acute ischaemic stroke outcomes following mechanical thrombectomy in the elderly versus their younger counterpart: a retrospective cohort study.
Article in BMJ open, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 13 citations in OpenAlex.
- Chronic Kidney Disease Increases Mortality and Reduces the Chance of a Favorable Outcome in Stroke Patients Treated with Mechanical Thrombectomy-Single-Center Study.Journal of clinical medicine · 2024Article
- Efficacy and safety of mechanical thrombectomy in the posterior cerebral circulation-a single center study.Scientific reports · 2024Article
- Mechanical thrombectomy in stroke patients of working age: Real-world outcomes in Sweden.European stroke journal · 2022Article
- Real-World Impact of Retrievable Stents for Acute Ischemic Stroke on Disability Utilizing the National Inpatient Sample.Interventional neurology · 2020Article
- Stroke in Older Survivors of Ischemic Stroke: Standard Care or Something Different?Geriatrics (Basel, Switzerland) · 2017Article
- Endovascular Stroke Treatment of Nonagenarians.AJNR. American journal of neuroradiology · 2017Article
- Outcome of mechanical thrombectomy in the very elderly for the treatment of acute ischemic stroke: the real world experience.Acta radiologica open · 2015Article
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesMany physicians debate the efficacy of mechanical thrombectomy for ischaemic stroke, but most agree that to establish potential benefit, patient selection must be examined further. People >80 years are a growing population of patients with ischaemic stroke but are largely excluded from clinical trials. The benefit of thrombectomy for them may be greatly reduced due to diminishing neuroplasticity and a larger number of medical comorbidities. To address this knowledge gap, we examined clinical and economic outcomes after mechanical thrombectomy in the ischaemic stroke population from the Nationwide Inpatient Sample. Our null hypotheses were that elderly patients (>80 years) would have a similar rate of inpatient mortality in comparison to their younger counterparts and incur a similar economic expense.
designRetrospective cohort study.
settingA 20% stratified sample of US community hospitals within the Nationwide Inpatient Sample.
participantsAll patients from 2008 to 2010 with a primary diagnosis of ischaemic stroke that received mechanical thrombectomy were included. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome was inpatient mortality. Secondary outcomes included hospital charges and length of stay.
resultsLess than 1% of all ischaemic stroke cases (9300) were treated with mechanical thrombectomy. Of these, 18% involved patients over 80 years of age. The odds of inpatient mortality in elderly patients treated with mechanical thrombectomy were approximately twice that of their younger counterparts (OR1.993, p < 0.001). The elderly experienced no significant difference in hospital charges (p=0.105) and length of stay (p=0.498).
conclusionsThe odds of inpatient mortality after mechanical thrombectomy in patients over 80 years of age were twice that of their younger counterparts. This is consistent with the overall worse prognosis seen in the natural history of this age group. Studies to better identify patients that would benefit from endovascular mechanical thrombectomy may improve outcomes and reduce the gap currently observed in age stratifications.
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