Cárdenas Sauder A, Vásquez Andrés, Ortiz Andrés F, Correa Paula A, Vera Daniela D, Ramírez Diego A, Florez Maria A, Ochoa Miguel E, Galvis Melquizidel, Vargas Oliverio, Ferreira Carlos A, Mantilla Daniel
Fellowship of Interventional Radiology, Universidad Autonoma de Bucaramanga, Santander, Colombia.
Universidad de la Sabana, Cundinamarca, Colombia.
Interv Neuroradiol. 2025 Apr;31(2):181-187. doi: 10.1177/15910199231153195. Epub 2023 Feb 7.
Background and aimsEndovascular treatment for cerebrovascular disease is accepted as a first-line option with level I evidence in patients with an early and late time of window of onset symptoms, and an additional option in patients who do not respond or with contraindications to systemic thrombolysis; nevertheless the efficacy and outcomes of some groups were not clear, one of them are patients aged 80 years and older, because they were excluded of the trials, so the evidence is controversial with significant heterogeneity, for that reason in our study, we decided to analyze the age in the patients treated in our stroke center, as a predictor of prognosis, and to provide a baseline for the establishment of personalized treatment plans.MethodsObservational, retrospective study of patients that received endovascular treatment for cerebrovascular disease in a Colombian stroke center between 2016 and 2020, continuous and categorical variables were compared using the Student's test and Chi-Square. To determine cut-off points in the variable against death and Rankin score variable on 90th day.ResultsIn total, 108 patients were recruited, 35 of them were of 80 or more years, and the mean age was 72.7 years, we found age as a significant variable to predict the risk in the population over 80 years of age [RR 3.37 CI (95% 1.14-103) = 0.029].ConclusionsAge younger than 80 is a significant predictor for results and long-term outcomes in patients suffering from stroke, and in patients older than 80 years old a Thrombolysis in Cerebral Infarction score 2b-3 is a predictor of good outcomes. Further studies are needed to evaluate the relationship between intrahospital complications and long-term outcomes.
背景与目的
血管内治疗被公认为是发病症状处于早期和晚期时间窗患者的一线治疗选择,对于对全身溶栓无反应或有禁忌证的患者则是另一选择;然而,某些群体的疗效和结果尚不清楚,其中之一是80岁及以上的患者,因为他们被排除在试验之外,所以证据存在争议且具有显著异质性。因此,在我们的研究中,我们决定分析在我们卒中中心接受治疗的患者年龄,作为预后的预测指标,并为制定个性化治疗方案提供基线。
方法
对2016年至2020年在哥伦比亚一家卒中中心接受脑血管疾病血管内治疗的患者进行观察性、回顾性研究,使用学生检验和卡方检验比较连续变量和分类变量。确定变量与第90天死亡和Rankin评分变量的切点。
结果
共招募了108名患者,其中35名年龄在80岁及以上,平均年龄为72.7岁,我们发现年龄是预测80岁以上人群风险(RR 3.37 CI(95% 1.14 - 103) = 0.029)的显著变量。
结论
80岁以下是卒中患者预后和长期结果的显著预测指标,80岁以上患者脑梗死溶栓评分2b - 3是良好预后的预测指标。需要进一步研究以评估院内并发症与长期结果之间的关系。