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

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

In: Journal of Neurology, 2014, vol. 261, no. 8, p. 1622-1627

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    Titre
    • Age dependency of safety and outcome of endovascular therapy for acute stroke
    Auteur
    • Luedi, Rudolf. Department of Neurology, Inselspital, University Hospital Bern and University of Bern, Freiburgstrasse 10, 3010, Bern, Switzerland
    • Hsieh, Kety. Department of Diagnostic and Interventional Neuroradiology, Inselspital, University Hospital Bern and University of Bern, Bern, Switzerland
    • Slezak, Agnieszka. Department of Neurology, Inselspital, University Hospital Bern and University of Bern, Freiburgstrasse 10, 3010, Bern, Switzerland
    • El-Koussy, Marwan. Department of Diagnostic and Interventional Neuroradiology, Inselspital, University Hospital Bern and University of Bern, Bern, Switzerland
    • Fischer, Urs. Department of Neurology, Inselspital, University Hospital Bern and University of Bern, Freiburgstrasse 10, 3010, Bern, Switzerland
    • Heldner, Mirjam. Department of Neurology, Inselspital, University Hospital Bern and University of Bern, Freiburgstrasse 10, 3010, Bern, Switzerland
    • Meisterernst, Julia. Department of Neurology, Inselspital, University Hospital Bern and University of Bern, Freiburgstrasse 10, 3010, Bern, Switzerland
    • Mono, Marie-Luise. Department of Neurology, Inselspital, University Hospital Bern and University of Bern, Freiburgstrasse 10, 3010, Bern, Switzerland
    • Zubler, Christoph. Department of Neurology, Inselspital, University Hospital Bern and University of Bern, Freiburgstrasse 10, 3010, Bern, Switzerland
    • Mordasini, Pasquale. Department of Neurology, Inselspital, University Hospital Bern and University of Bern, Freiburgstrasse 10, 3010, Bern, Switzerland
    • Ozdoba, Christoph. Department of Diagnostic and Interventional Neuroradiology, Inselspital, University Hospital Bern and University of Bern, Bern, Switzerland
    • Mattle, Heinrich. Department of Neurology, Inselspital, University Hospital Bern and University of Bern, Freiburgstrasse 10, 3010, Bern, Switzerland
    • Schroth, Gerhard. Department of Diagnostic and Interventional Neuroradiology, Inselspital, University Hospital Bern and University of Bern, Bern, Switzerland
    • Gralla, Jan. Department of Diagnostic and Interventional Neuroradiology, Inselspital, University Hospital Bern and University of Bern, Bern, Switzerland
    • Arnold, Marcel. Department of Neurology, Inselspital, University Hospital Bern and University of Bern, Freiburgstrasse 10, 3010, Bern, Switzerland
    • Jung, Simon. Department of Neurology, Inselspital, University Hospital Bern and University of Bern, Freiburgstrasse 10, 3010, Bern, Switzerland
    Type de document
    • Postprint
    Langue
    • Anglais
    Publié dans
    • Journal of Neurology, 2014, vol. 261, no. 8, p. 1622-1627. Springer Berlin Heidelberg
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:324938
    Summary
    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 90years. 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 3months. 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 26years 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 90years, 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.