Abstract
Objectives Thrombectomy decisions in the elderly patients are often difficult, because the benefit/risk ratio is less favourable than in younger patients. Our aim was to evaluate the 90-day outcomes of elderly patients (aged ≥80 years) who underwent ET at Wellington Regional Hospital.
Methods Data from a prospectively maintained database of patients undergoing ET for AIS at Wellington Regional Hospital (WRH) between 1 July 2019 and 30 June 2022 were reviewed. Patients aged ≥80 years were included in the study, and their demographic, procedural and outcome variables, including 90-day modified Rankin Scale (mRS) score, and mortality were recorded.
Results A total of 49 elderly patients underwent ET during the study period: mean age 84.1 years, 53% (26/49) female, and 10% (5/49) Maori. All but one had a pre-morbid mRS of 0–2. Twenty-seven (55%) received thrombolysis prior to ET. Twenty-eight (57%) patients presented directly to WRH; with the remaining being transferred from a secondary hospital. The median time from onset to reperfusion was 319 minutes (IQR, 256–445). The mean NIHSS was 17.1 pre-procedure, and 10.7 at 24 hours post-procedure. Post-procedure reperfusion (TICI ≥ 2b) was achieved in 79.6% (39/49). At 90 days, functional independence (mRS 0–2) was observed in 24.5% (12/49), and a good functional outcome (mRS ≤ 3) was observed in 49.6% (23/49). The 90-day mortality was 32.7% (16/49).
Conclusion The rates of good functional outcome and mortality, in elderly patients undergoing ET at Wellington Regional Hospital, are similar to those reported in large clinical trials.
