Impact of Frality on In-Hospital Outcomes of Patients With Acute Ischemic Stroke Undergoing Mechanical Thrombectomy

Document Type

Conference Proceeding

Publication Date

5-2025

Publication Title

Journal of the Society for Cardiovascular Angiography and Interventions

Abstract

Background: Frailty is a clinical syndrome characterized by reduced physiological reserve and increased vulnerability to adverse health outcomes, potentially impacting patients undergoing mechanical thrombectomy for acute ischemic stroke due to large vessel occlusion (LVO). This study aims to evaluate the influence of frailty on in-hospital outcomes in these high-risk patients. Methods: We conducted a retrospective analysis of the National Inpatient Sample (2016-2021), identifying patients with LVO stroke undergoing mechanical thrombectomy. Frailty was defined using Johns Hopkins Adjusted Clinical Groups (ACG) frailty-defining diagnoses. Propensity score matching was applied, producing two cohorts of 3,145 patients each. A two-stage multivariable logistic regression was performed to evaluate independent predictors of in-hospital outcomes. Results: Frail patients had higher in-hospital mortality (12.06% vs. 9.90%, P=0.004), seizures (2.35% vs. 1.65%, P=0.048), major adverse cardiac event (MACE) (15.29% vs. 13.51%, P=0.044), pulmonary embolism (2.38% vs. 1.62%, P=0.031), and hospital-acquired pneumonia (6.10% vs. 4.80%, P=0.023) compared to non- frail patients. Conclusions: Frailty is associated with worse outcomes in patients undergoing mechanical thrombectomy for LVO, including higher mortality, MACE, and pneumonia. These findings highlight the importance of pre-procedural risk stratification and tailored management to improve outcomes in frail patients.

Volume

4

Issue

5 Suppl

First Page

66

Comments

Society for Cardiovascular Angiography and Interventions SCAI 48th Annual Scientific Sessions, May 1-3, 2025, Washington, DC

Last Page

66

DOI

10.1016/j.jscai.2025.103511

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