Figueiredo Sofia, Carvalho Andreia, Rodrigues Marta, Cunha André, Paredes Ludovina, Costa Henrique, Barros Pedro, Gregório Tiago, Ribeiro Manuel, Castro Sérgio, Veloso Miguel
Neurology Department, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal.
Neurology Department, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal.
J Stroke Cerebrovasc Dis. 2017 Dec;26(12):2949-2953. doi: 10.1016/j.jstrokecerebrovasdis.2017.07.020. Epub 2017 Aug 23.
Evidence on stent retriever-based thrombectomy (SRT) efficacy in elderly patients is controversial. This study aimed to analyze safety and efficacy outcomes in octogenarians submitted to SRT.
Analysis was based on a prospective observational registry of patients with stroke because of anterior circulation large-vessel occlusion treated with SRT at our center between January 2015 and September 2016. Patients were dichotomized into 2 age groups: ≤80 and >80 years old. Outcomes at 90 days were assessed: "excellent outcome" (a modified Rankin scale [mRs] score of 0-1) and "good outcome" (a mRs score of 0-2).
A total of 141 patients were included: 35 (24.8%) >80 years old and 106 (71.2%) ≤80 years old; 43.4% of patients in the younger group and 25.7% of patients in the older group achieved an "excellent outcome." A "good outcome" was achieved in 65.1% of patients in the younger group, and 60% of patients in the older group; crude odds ratio (OR) for "excellent outcome" was 0.452 (P = .067). Crude OR for "good outcome" was 0.804 (P = .587). After adjusting for gender, National Institutes of Health Stroke Scale score at admission, Alberta Stroke Program Early CT Score, and thrombolysis, the OR was 0.450 (P = .100) and 1.217 (P = .686) for "excellent" and "good" outcomes, respectively.
In this cohort, 60% of elderly patients regained functional independence at 3 months after SRT. Although age may be a prognostic factor, patients should not be excluded from SRT based on age criteria.
关于基于支架取栓术（SRT）在老年患者中的疗效证据存在争议。本研究旨在分析接受SRT的八旬老人的安全性和疗效结果。
分析基于2015年1月至2016年9月在我们中心接受SRT治疗的因前循环大血管闭塞导致中风患者的前瞻性观察登记。患者被分为两个年龄组：≤80岁和>80岁。评估90天时的结果：“良好结果”（改良Rankin量表[mRs]评分为0 - 1）和“较好结果”（mRs评分为0 - 2）。
共纳入141例患者：35例（24.8%）>80岁，106例（71.2%）≤80岁；较年轻组43.4%的患者和较年长组25.7%的患者获得“良好结果”。较年轻组65.1%的患者和较年长组60%的患者获得“较好结果”；“良好结果”的粗比值比（OR）为0.452（P = 0.067）。“较好结果”的粗OR为0.804（P = 0.587）。在调整性别、入院时美国国立卫生研究院卒中量表评分、阿尔伯塔卒中项目早期CT评分和溶栓治疗后，“良好”和“较好”结果的OR分别为0.450（P = 0.100）和1.217（P = 0.686）。
在该队列中，60%的老年患者在SRT后3个月恢复了功能独立性。虽然年龄可能是一个预后因素，但不应根据年龄标准将患者排除在SRT之外。
