title: Age dependency of safety and outcome of endovascular therapy for acute stroke.
abstract: 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.
authors.affiliation: Department of Neurology, Inselspital, University Hospital Bern and University of Bern, Freiburgstrasse 10, 3010, Bern, Switzerland.
authors.forename: Rudolf
authors.initials: R
authors.lastname: Luedi
authors.forename: Kety
authors.initials: K
authors.lastname: Hsieh
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Slezak
authors.forename: Marwan
authors.initials: M
authors.lastname: El-Koussy
authors.forename: Urs
authors.initials: U
authors.lastname: Fischer
authors.forename: Mirjam R
authors.initials: MR
authors.lastname: Heldner
authors.forename: Julia
authors.initials: J
authors.lastname: Meisterernst
authors.forename: Marie-Luise
authors.initials: ML
authors.lastname: Mono
authors.forename: Christoph
authors.initials: C
authors.lastname: Zubler
authors.forename: Pasquale
authors.initials: P
authors.lastname: Mordasini
authors.forename: Christoph
authors.initials: C
authors.lastname: Ozdoba
authors.forename: Heinrich P
authors.initials: HP
authors.lastname: Mattle
authors.forename: Gerhard
authors.initials: G
authors.lastname: Schroth
authors.forename: Jan
authors.initials: J
authors.lastname: Gralla
authors.forename: Marcel
authors.initials: M
authors.lastname: Arnold
authors.forename: Simon
authors.initials: S
authors.lastname: Jung
mesh_terms: D000208:Acute Disease; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D015331:Cohort Studies; D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D020521:Stroke / Q000401:mortality / Q000628:therapy*; D055815:Young Adult