Abstract：
OBJECTIVE: To assess outcomes of mechanical thrombectomy (MT) in nonagenarians suffering from acute ischaemic stroke (AIS) in a 1-year follow-up.
OBJECTIVE: Age is a factor associated with both the occurrence of AIS and a poorer prognosis. As the population ages, the prevalence of AIS among the very old (90 and older) is expected to rise. Data on long-term outcomes of MT, being the optimal treatment of AIS caused by large vessel occlusions, is scarce in the population of nonagenarians.
METHODS: We analysed all AIS patients treated with MT in a single Comprehensive Stroke Centre. We compared two subgroups: nonagenarians (people aged 90-99) and controls ( < 90 years) in terms of cardiovascular risk factors profile, stroke severity, treatment course, presence of in-hospital complications, and outcomes (mortality and good functional outcome defined as modified Rankin Scale ≤ 2) at discharge and at 90- and 365-day follow-ups.
RESULTS: Nonagenarians were more commonly female and suffering from atrial fibrillation. They more often developed urinary tract infection during hospitalisation. Stroke severity, treatment course and in-hospital outcomes were comparable between the groups. Nonagenarians had non-significantly higher 90-day and 365-day mortality, and a significantly lower rate of good functional outcomes after 90 days (25.0% vs 57.7%, p = 0.011) and 365 days (31.5% vs 61.0%, p = 0.020).
CONCLUSIONS: Despite worse outcomes than in younger patients, 25% of nonagenarians were functionally independent three months after MT, and almost one in three of them were so a year after the procedure, thereby showing the benefits of the treatment in this group.
OBJECTIVE: Age is a factor associated with both the occurrence of AIS and a poorer prognosis. As the population ages, the prevalence of AIS among the very old (90 and older) is expected to rise. Data on long-term outcomes of MT, being the optimal treatment of AIS caused by large vessel occlusions, is scarce in the population of nonagenarians.
METHODS: We analysed all AIS patients treated with MT in a single Comprehensive Stroke Centre. We compared two subgroups: nonagenarians (people aged 90-99) and controls ( < 90 years) in terms of cardiovascular risk factors profile, stroke severity, treatment course, presence of in-hospital complications, and outcomes (mortality and good functional outcome defined as modified Rankin Scale ≤ 2) at discharge and at 90- and 365-day follow-ups.
RESULTS: Nonagenarians were more commonly female and suffering from atrial fibrillation. They more often developed urinary tract infection during hospitalisation. Stroke severity, treatment course and in-hospital outcomes were comparable between the groups. Nonagenarians had non-significantly higher 90-day and 365-day mortality, and a significantly lower rate of good functional outcomes after 90 days (25.0% vs 57.7%, p = 0.011) and 365 days (31.5% vs 61.0%, p = 0.020).
CONCLUSIONS: Despite worse outcomes than in younger patients, 25% of nonagenarians were functionally independent three months after MT, and almost one in three of them were so a year after the procedure, thereby showing the benefits of the treatment in this group.
摘要：
目的：评估急性缺血性卒中（AIS）患者机械血栓切除术（MT）1年随访结果。
目的：年龄是与AIS的发生和预后较差相关的因素。随着人口老龄化,老年人(90岁及以上)中AIS的患病率预计会上升。MT的长期结果数据，是由大血管闭塞引起的AIS的最佳治疗方法，在非成年人口中很少。
方法：我们分析了在一个综合卒中中心接受MT治疗的所有AIS患者。我们比较了两个亚组：非肥胖人群（90-99岁的人）和对照组（<90岁）在心血管危险因素方面，中风严重程度,疗程,住院并发症的存在，出院时以及90天和365天随访时的结局（死亡率和良好功能结局定义为改良Rankin量表≤2）。
结果：非成年患者更常见的是女性，患有心房颤动。他们在住院期间更常发生尿路感染。卒中严重程度,两组间的治疗疗程和院内结局具有可比性.九龄老人的90天和365天死亡率没有显着升高，90天后良好功能结局的比率显着降低（25.0％vs57.7％，p=0.011)和365天(31.5%对61.0%，p=0.020)。
结论：尽管结果比年轻患者差，25％的非成年患者在MT后三个月在功能上独立，几乎三分之一的人在手术后一年，从而显示了该组治疗的益处。
目的：年龄是与AIS的发生和预后较差相关的因素。随着人口老龄化,老年人(90岁及以上)中AIS的患病率预计会上升。MT的长期结果数据，是由大血管闭塞引起的AIS的最佳治疗方法，在非成年人口中很少。
方法：我们分析了在一个综合卒中中心接受MT治疗的所有AIS患者。我们比较了两个亚组：非肥胖人群（90-99岁的人）和对照组（<90岁）在心血管危险因素方面，中风严重程度,疗程,住院并发症的存在，出院时以及90天和365天随访时的结局（死亡率和良好功能结局定义为改良Rankin量表≤2）。
结果：非成年患者更常见的是女性，患有心房颤动。他们在住院期间更常发生尿路感染。卒中严重程度,两组间的治疗疗程和院内结局具有可比性.九龄老人的90天和365天死亡率没有显着升高，90天后良好功能结局的比率显着降低（25.0％vs57.7％，p=0.011)和365天(31.5%对61.0%，p=0.020)。
结论：尽管结果比年轻患者差，25％的非成年患者在MT后三个月在功能上独立，几乎三分之一的人在手术后一年，从而显示了该组治疗的益处。
