Abstract
INTRODUCTION: The clinical factor impact on outcomes after endovascular thrombectomy (EVT) in patients aged ≥70 years remains incompletely understood. We aimed to identify predictors of good outcomes after EVT in patients aged ≥70 years, defined as a modified Rankin Scale (mRS) score of 0-2. METHODS: This retrospective, single-center cohort study included 94 patients aged ≥70 years with acute ischemic stroke who underwent EVT. Participants were stratified into septuagenarians (n = 44) and octo/nonagenarians (n = 50). We evaluated post-EVT modified thrombolysis in cerebral infarction reperfusion grade, symptomatic intracerebral hemorrhage, and mRS score at 3 months follow-up as outcomes. Both multivariable (LR) and Bayesian logistic regression (BLR) and sensitivity analyses were conducted to derive adjusted odds ratio (aOR) and assess the probabilistic associations between clinical variables and outcomes. RESULTS: At presentation, the median ischemic core was higher in octo/nonagenarians compared to septuagenarians (20 mL vs. 4 mL, p = 0.0464); median Alberta Stroke Program Early CT Score was lower (7 vs. 8, p = 0.0112). Higher Fazekas grades of leukoaraiosis were more frequent in octo/nonagenarians (p = 0.0297) than in septuagenarians. Good mRS outcomes were achieved by 27.3% of septuagenarians vs. 8.0% of octo/nonagenarians (p = 0.0274). In the multivariable LR, age was not an independent predictor of poor outcomes (aOR 2.40; 95% CI, 0.65-10.08; p = 0.1991). BLR identified higher National Institutes of Health Stroke Scale scores [odds ratio (OR) 0.90; 95% credible interval, 0.81-0.98] associated with poorer outcomes, whereas prior intravenous thrombolysis (OR 6.59; 1.16-23.09) predicted better outcomes. BLR did not show probabilistic certainty of age as a predictor of functional outcomes. Including infarct core in the model did not impact sensitivity analysis results. CONCLUSION: Age was not independently associated with functional outcomes. Age-related differences in outcomes may be mediated by initial stroke characteristics rather than age. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, identifier NCT06953427.