Abstract
Byline: Vera Sharashidze, New York Univ, New York, NY; Hao Ying, Univ of Miami, Miami, FL; Kefeng Wang, Univ of Miami Med Sch, Miami, FL; Hannah Gardener, Univ of Miami Med Sch, Miami, FL; Ayham Alkhachroum, Univ of Miami, Miami, FL; Carolina M Gutierrez, UNIVERISTY OF MIAMI MILLER SCH, Miami, FL; David Rose, UNIVERSITY OF SOUTH FLORIDA, Tampa, FL; Nastajjia Krementz, Univ of Miami, Miami, FL; Chuanhui Dong, UNIVERSITY OF MIAMI, Miami, FL; Brijesh P Mehta, Memorial Healthcare System, Miami Lakes, FL; Angus Jameson, FL; Tatjana Rundek, MILLER SCHL OF MEDICINE UNIV M, Miami, FL; Dileep R Yavagal, UNIVERSITY OF MIAMI MILLER SCH, Miami, FL; Jose G Romano, U Miami, Pinecrest, FL; Ralph L Sacco, UNIVERSITY OF MIAMI, Miami, FL; Negar Asdaghi, UNIVERSITY OF MIAMI MILLER SCHOOL, Miami, FL Introduction: Patients older than 80 years of age are under-represented in randomized trials of endovascular thrombectomy (EVT). In the large Florida Stroke Registry, we aimed to evaluate the impact of age on EVT outcomes in routine clinical practice. Methods: Prospectively collected data from Get with the Guidelines- Stroke hospitals participating in the Florida Stroke Registry from January 2010 to April 2020 were reviewed. The impact of age on discharge outcomes was studied using multivariate analysis with generalized estimating equations adjusting for sex, race, NIHSS, time from onset to treatment, intravenous thrombolysis, and hospital-based characteristics (size, EVT volume, and stroke center certification), and region. Results: Among 8,344 EVT patients (mean age 71Ø15, 49% male), 32.9% were [greater than or equal] 80 years of age. Patients [greater than or equal] 80 years were more likely hypertensive (76% vs 63%), with atrial fibrillation (56% vs 26%), presented earlier to the hospital (onset to arrival 108 vs 126 min), with more severe strokes (NIHSS 17 (IQR=11) vs 15 (IQR=11)) and less likely to ambulate independently at baseline. Short term discharge outcomes and treatment complications, stratified by age [greater than or equal] 80 or < 80 are shown in the Table. In multivariable analysis, elderly patients were less likely to achieve independent ambulation (OR: 0.37, CI 0.32, 0.43) and be discharged home/rehabilitation (OR 0.36, CI 0.33, 0.40). In the continuously adjusted model, for every year increase in age, the odds of independent ambulation decreased by 3% per year (p<0.001) for patients 60-80 years of age and decreased by 7% for those over the age of 80. Discussion: In routine practice, one third of endovascularly treated LVO patients are over 80. Our data shows that EVT is safe in this population; however, age remains an independent predictor of poor discharge outcomes, especially in those over the age of 80.
