Time-outcome relationship in acute large-vessel occlusion exists across all ages: subanalysis of RESCUE-Japan Registry 2.

Abstract

Early reperfusion after endovascular thrombectomy is associated with an improved outcome in ischemic stroke patients; however, the time dependency in elderly patients remains unclear. We investigated the time-outcome relationships in different age subgroups. Of 2420 patients enrolled in the RESCUE-Japan Registry 2 study, a study based on a prospective registry of stroke patients with acute cerebral large-vessel occlusion at 46 centers, we analyzed the data of 1010 patients with successful reperfusion after endovascular therapy (mTICI of 2b or 3). In 3 age subgroups (< 70, 70 to < 80, and ≥ 80 years), the mRS scores at 90 days were analyzed according to 4 categories of onset-to-reperfusion time (< 180, 180 to < 240, 240 to < 300, and ≥ 300 min). In each age subgroup, the distributions of mRS scores were better with shorter onset-to-reperfusion times. The adjusted common odds ratios for better outcomes per 1-category delay in onset-to-reperfusion time were 0.66 (95% CI 0.55-0.80) in ages < 70 years, 0.66 (95% CI 0.56-0.79) in ages 70 to < 80 years, and 0.83 (95% CI 0.70-0.98) in ages ≥ 80 years. Early reperfusion was associated with better outcomes across all age subgroups. Achieving early successful reperfusion is important even in elderly patients.

• Authors: Kenichi Todo, Shinichi Yoshimura, Kazutaka Uchida, Hiroshi Yamagami, Nobuyuki Sakai, Haruhiko Kishima, Hideki Mochizuki, Masayuki Ezura, Yasushi Okada, Kazuo Kitagawa, Kazumi Kimura, Makoto Sasaki, Norio Tanahashi, Kazunori Toyoda, Eisuke Furui, Yuji Matsumaru, Kazuo Minematsu, Takaya Kitano, Shuhei Okazaki, Tsutomu Sasaki, Manabu Sakaguchi, Masatoshi Takagaki, Takeo Nishida, Hajime Nakamura, Takeshi Morimoto, RESCUE-Japan Registry 2 Investigators
• Journal: Scientific reports (Sci Rep) Vol. 11 Issue 1 Pg. 12782 (06 17 2021) ISSN: 2045-2322 [Electronic] England
• PMID: 34140563 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Aged
• Aged, 80 and over
• Cerebrovascular Disorders (epidemiology)
• Female
• Humans
• Japan (epidemiology)
• Male
• Middle Aged
• Odds Ratio
• Registries
• Reperfusion
• Time Factors