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

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Abstract

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 90 years. 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 3 months. 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 26 years 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 90 years, 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.

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Ethical standard

The study was performed according to the ethical guidelines of the Canton of Bern and with corresponding permission.

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Authors and Affiliations

  1. Department of Neurology, Inselspital, University Hospital Bern and University of Bern, Freiburgstrasse 10, 3010, Bern, Switzerland

    Rudolf Luedi, Agnieszka Slezak, Urs Fischer, Mirjam R. Heldner, Julia Meisterernst, Marie-Luise Mono, Christoph Zubler, Pasquale Mordasini, Heinrich P. Mattle, Marcel Arnold & Simon Jung

  2. Department of Diagnostic and Interventional Neuroradiology, Inselspital, University Hospital Bern and University of Bern, Bern, Switzerland

    Kety Hsieh, Agnieszka Slezak, Marwan El-Koussy, Christoph Ozdoba, Gerhard Schroth, Jan Gralla & Simon Jung

Authors
  1. Rudolf Luedi
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  2. Kety Hsieh
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  3. Agnieszka Slezak
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  4. Marwan El-Koussy
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  5. Urs Fischer
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  6. Mirjam R. Heldner
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  7. Julia Meisterernst
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  8. Marie-Luise Mono
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  9. Christoph Zubler
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  10. Pasquale Mordasini
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  11. Christoph Ozdoba
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  12. Heinrich P. Mattle
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  13. Gerhard Schroth
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  14. Jan Gralla
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  15. Marcel Arnold
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  16. Simon Jung
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Corresponding author

Correspondence to Heinrich P. Mattle.

Additional information

R. Luedi, K. Hsieh, M. Arnold and S. Jung have contributed equally to this work.

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Luedi, R., Hsieh, K., Slezak, A. et al. Age dependency of safety and outcome of endovascular therapy for acute stroke. J Neurol 261, 1622–1627 (2014). https://doi.org/10.1007/s00415-014-7401-0

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  • DOI: https://doi.org/10.1007/s00415-014-7401-0

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