Patterns and Outcomes of Endovascular Thrombectomy Among Patients Over Age 80 Years: The Florida Stroke Registry.

Abstract

Background: Older patients (≥80 years of age) were under-represented in randomized trials of endovascular thrombectomy (EVT). In the large Florida Stroke Registry (FSR), we aimed to evaluate the characteristics of the older patients receiving EVT in routine practice and to study the impact of age on EVT outcomes.

Methods and results: Data prospectively collected from Get With The Guidelines-Stroke hospitals in the FSR from January 2010 to December 2022 were analyzed for EVT outcomes. Among patients receiving EVT, characteristics associated with age ≥80 years and the impact of age on EVT outcomes of discharge directly to home or acute inpatient rehabilitation, and independent ambulation at discharge were studied using multivariable analysis with generalized estimating equations. Among 20 004 EVT FSR patients (mean age 71±15, 50% women), 29% were ≥80 years of age. In multivariable analysis, older patients with EVT had a similar rate of symptomatic intracerebral hemorrhage and in hospital mortality but were less likely to achieve independent ambulation at discharge (odds ratio [OR]: 0.44 [95% CI, 0.39-0.49]), be discharged directly home (OR: 0.46 [95% CI, 0.42-0.51]) or to a rehabilitation facility (OR: 0.68 [95% CI, 0.61-0.75]).

Conclusions: In routine practice, close to 30% of EVT treated stroke patients are over the age of 80 years. Our data shows that EVT is safe in this population; however, age remains an independent predictor of poor discharge outcomes post EVT.