Too bad to treat? Predicting clinical outcome after mechanical thrombectomy in octogenarians

Akarsu F. G., Doğan B., Eryıldız E. S., Memmedova F., Mehdi̇yev Z., AYKAÇ Ö., ...Daha Fazla

Clinical Neurology and Neurosurgery, cilt.226, 2023 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 226
  • Basım Tarihi: 2023
  • Doi Numarası: 10.1016/j.clineuro.2023.107635
  • Dergi Adı: Clinical Neurology and Neurosurgery
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, CAB Abstracts, EMBASE, MEDLINE
  • Anahtar Kelimeler: Ischemic stroke, Outcome, Octogenarian stroke, Evans Index, THRIVE score, ACUTE ISCHEMIC-STROKE, TOTALED HEALTH-RISKS, ENDOVASCULAR TREATMENT, CT, OCCLUSION, THERAPY, SCORE, TPA
  • Eskişehir Osmangazi Üniversitesi Adresli: Evet

Özet

Objectives: We aimed to reveal the effect of the totaled health risk in vascular events (THRIVE) score and the radiological parameters of the Alberta stroke program early computed tomography score (ASPECTS), the Van Swieten Scale (VSS) score, and the Evans Index on clinical outcomes in patients over 80 years of age who underwent endovascular thrombectomy (EVT). Materials and Methods: We retrospectively analyzed anterior ischemic stroke (AIS) patients over 80 years of age who underwent EVT between May 2017 and April 2022. Good functional outcome was accepted as a 90-day modified Rankin Scale (mRS) score of 0–2. We constructed three models to compare to the mRS (model 1: THRIVE, CTA-ASPECT; model 2: THRIVE, CTA-ASPECT, Evans Index; model 3: THRIVE, CTA-ASPECT, Evans Index, VSS). Results: A total of 39 octogenarian patients with thrombolysis in cerebral infarction (TICI) 2c-3 recanalization were selected, and their 90-day mRS scores were compared. Of these, 19 patients (48%) showed good outcomes. In multivariable receiver operating characteristic (ROC) analyses, the AUC of model 1 was 0.797 (95% confidence interval [CI], 0.638–0.909), the AUC of model 2 was 0.862 (95% CI, 0.714–0.951), and the AUC of model 3 was 0.905 (95% CI, 0.768–0.975). Conclusions: Evaluation of the THRIVE score, which measures vascular disease burden and stroke severity, together with the radiological parameters of ASPECTS score, VSS score, and the Evans Index, provides useful guidance in predicting the clinical outcomes of elderly AIS patients after EVT.