Age dependency of safety and outcome of endovascular therapy for acute stroke

Lüdi, Rudolf; Hsieh, Kety Wha-Vei; Slezak, Agnieszka Anna; El-Koussy, Marwan; Fischer, Urs; Heldner, Mirjam Rachel; Meisterernst, Julia Anne; Mono, Marie-Luise; Zubler, Christoph; Mordasini, Pasquale; Ozdoba, Christoph; Mattle, H.P.; Schroth, Gerhard; Gralla, Jan; Arnold, Marcel; Jung, Simon (2014). Age dependency of safety and outcome of endovascular therapy for acute stroke. Journal of neurology, 261(8), pp. 1622-1627. Springer-Medizin-Verlag 10.1007/s00415-014-7401-0

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Elderly patients generally experience less favorable outcomes and higher mortality after acute stroke than younger patients. The aim of this study was to analyze the influence of age on outcome and safety after endovascular therapy in a large cohort of patients aged between 20 and 90 years. We prospectively acquired data of 1,000 stroke patients treated with endovascular therapy at a single center. Logistic regression analysis was performed to determine predictors of outcome and linear regression analysis to evaluate the association of age and outcome after 3 months. Younger age was an independent predictor of favorable outcome (OR 0.954, p < 0.001) and survival (OR 0.947, p < 0.001) in multivariate regression analysis. There was a linear relationship between age and outcome. Ever increase in 26 years of age was associated with an increase in the modified Rankin Scale of 1 point (p < 0.001). However, increasing age was not a risk factor for symptomatic (p = 0.086) or asymptomatic (p = 0.674) intracerebral hemorrhage and did not influence recanalization success (p = 0.674). Advancing age was associated with a decline of favorable outcomes and survival after endovascular therapy. This decline was linear from age 20 to 90 years, but was not related to lower recanalization rates or higher bleeding risk in the elderly. The efficacy of endovascular stroke therapy seems to be preserved also in the elderly and other factors than efficacy of endovascular therapy such as decreased plasticity are likely to explain the worse outcome with advancing age.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology
04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic and Interventional Neuroradiology

UniBE Contributor:

Lüdi, Rudolf; Hsieh, Kety Wha-Vei; Slezak, Agnieszka Anna; El-Koussy, Marwan; Fischer, Urs; Heldner, Mirjam Rachel; Meisterernst, Julia Anne; Mono, Marie-Luise; Zubler, Christoph; Mordasini, Pasquale; Ozdoba, Christoph; Mattle, Heinrich; Schroth, Gerhard; Gralla, Jan; Arnold, Marcel and Jung, Simon

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0340-5354

Publisher:

Springer-Medizin-Verlag

Language:

English

Submitter:

Valentina Rossetti

Date Deposited:

10 Oct 2014 22:17

Last Modified:

29 Dec 2017 10:05

Publisher DOI:

10.1007/s00415-014-7401-0

PubMed ID:

24916832

Additional Information:

Arnold M und Jung S equally contributing authors

BORIS DOI:

10.7892/boris.54202

URI:

https://boris.unibe.ch/id/eprint/54202

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