Characteristics of frail and non-frail older acute ischaemic stroke patients that underwent endovascular thrombectomy
Variable . | Not frail (CFS 1–3) n = 94 . | Frail (CFS > 3) n = 104 . | P value . |
---|---|---|---|
Baseline characteristics and investigations | |||
Age (years), mean (SD) | 75.7 (4.3) | 80.4 (5.9) | <0.001 |
Female, % (n) | 41.5 (39) | 61.5 (64) | 0.005 |
Race, % (n) | |||
Chinese | 80.9 (76) | 69.2 (72) | 0.240 |
Malay | 10.6 (10) | 22.1 (23) | 0.120 |
Indian | 5.3 (5) | 6.7 (7) | 1.000 |
Others | 3.2 (3) | 1.9 (2) | 1.000 |
Co-morbidities | |||
Hypertension, % (n) | 77.7 (73) | 90.4 (94) | 0.014 |
Diabetes mellitus, % (n) | 30.9 (29) | 35.6 (37) | 0.481 |
Dyslipidaemia, % (n) | 64.9 (61) | 70.2 (73) | 0.426 |
Ischaemic heart disease, % (n) | 25.5 (24) | 26.9 (28) | 0.824 |
Smoking, % (n) | 6.4 (6) | 1.9 (2) | 0.153 |
Atrial fibrillation, % (n) | 52.1 (49) | 71.2 (74) | 0.006 |
Previous stroke/TIA, % (n) | 8.6 (8) | 21.2 (22) | 0.014 |
Cognitive impairment, % (n) | 4.3 (4) | 18.3 (19) | 0.002 |
NIHSS on arrival, median (IQR) | 18 (13–23) | 20 (16–23) | 1.000 |
TOAST, % (n) | |||
Large artery atherosclerosis | 33.0 (30) | 17.6 (18) | 0.014 |
Cardioembolism | 51.6 (47) | 70.6 (72) | 0.007 |
Small vessel occlusion | 0 | 0 | N/A |
Stroke of other determined aetiology | 0.0 (0) | 1.0 (1) | 1.000 |
Stroke of undetermined aetiology | 15.4 (14) | 2.0 10.8 (11) | 0.342 |
Site of occlusion, % (n) | |||
M1-MCA | 48.9 (46) | 49.0 (51) | 0.989 |
M2-MCA | 9.6 (9) | 6.7 (7) | 0.463 |
M3-MCA | 3.2 (3) | 2.9 (3) | 1.000 |
Carotid T | 16.0 (15) | 22.1 (23) | 0.272 |
Tandem | 11.7 (11) | 8.7 (9) | 0.477 |
Basilar artery | 8.5 (8) | 9.6 (10) | 0.787 |
Multi-vessel | 2.1 (2) | 1.0 (1) | 0.605 |
Procedure timings | |||
Time from onset to arrival (min), median (IQR) | 85 (42–184) | 73 (38–177) | 0.355 |
Time from door to imaging (min), median (IQR) | 1 (0–12) | 2 (0–13) | 0.580 |
Time from door to needle (min), median (IQR) | 48 (40–57) | 49 (42–59) | 0.560 |
Time from onset to puncture (min), median (IQR) | 214 (165–308) | 210 (161–310) | 0.897 |
Time taken for clot retrieval (min), median (IQR) | 35 (21–58) | 35 (20–60) | 0.889 |
Bridging thrombolysis, % (n) | 62.8 (59) | 57.7 (60) | 0.467 |
Laboratory findings, mean (SD) | |||
Creatinine (μmol/l) | 94.3 (105.1) | 111.5 (81.2) | 0.198 |
Haemoglobin (g/dl) | 13.0 (1.7) | 12.2 (2.2) | 0.005 |
Albumin (g/l) | 34.0 (4.0) | 32.3 (4.6) | 0.018 |
Outcomes | |||
Outcomes in hospital | |||
Duration of hospitalisation (days), median (IQR) | 15 (8–28) | 15 (8–24) | 0.539 |
In-hospital mortality, % (n) | 9.6 (9) | 18.3 (19) | 0.080 |
Carer required, % (n) | 72.8 (59) | 91.6 (76) | 0.002 |
mRS at 3 months, % (n) | |||
0 | 14.9 (14) | 4.8 (5) | 0.016 |
1 | 8.5 (8) | 3.8 (4) | 0.170 |
2 | 7.4 (7) | 7.7 (8) | 0.948 |
3 | 21.3 (20) | 14.4 (15) | 0.207 |
4 | 25.5 (24) | 29.8 (31) | 0.502 |
5 | 9.6 (9) | 16.3 (17) | 0.159 |
6 | 12.8 (12) | 23.1 (24) | 0.060 |
Stroke outcomes | |||
Functional independence at 3 months (mRS 0–2), % (n) | 30.9 (29) | 16.3 (17) | 0.016 |
Successful reperfusion (mTICI ≥2b), % (n) | 87.8 (79) | 80.0 (80) | 0.147 |
Symptomatic ICH, % (n) | 5.3 (5) | 2.9 (3) | 0.481 |
Haemorrhagic transformation, % (n) | 26.1 (24) | 29.7 (30) | 0.576 |
Variable . | Not frail (CFS 1–3) n = 94 . | Frail (CFS > 3) n = 104 . | P value . |
---|---|---|---|
Baseline characteristics and investigations | |||
Age (years), mean (SD) | 75.7 (4.3) | 80.4 (5.9) | <0.001 |
Female, % (n) | 41.5 (39) | 61.5 (64) | 0.005 |
Race, % (n) | |||
Chinese | 80.9 (76) | 69.2 (72) | 0.240 |
Malay | 10.6 (10) | 22.1 (23) | 0.120 |
Indian | 5.3 (5) | 6.7 (7) | 1.000 |
Others | 3.2 (3) | 1.9 (2) | 1.000 |
Co-morbidities | |||
Hypertension, % (n) | 77.7 (73) | 90.4 (94) | 0.014 |
Diabetes mellitus, % (n) | 30.9 (29) | 35.6 (37) | 0.481 |
Dyslipidaemia, % (n) | 64.9 (61) | 70.2 (73) | 0.426 |
Ischaemic heart disease, % (n) | 25.5 (24) | 26.9 (28) | 0.824 |
Smoking, % (n) | 6.4 (6) | 1.9 (2) | 0.153 |
Atrial fibrillation, % (n) | 52.1 (49) | 71.2 (74) | 0.006 |
Previous stroke/TIA, % (n) | 8.6 (8) | 21.2 (22) | 0.014 |
Cognitive impairment, % (n) | 4.3 (4) | 18.3 (19) | 0.002 |
NIHSS on arrival, median (IQR) | 18 (13–23) | 20 (16–23) | 1.000 |
TOAST, % (n) | |||
Large artery atherosclerosis | 33.0 (30) | 17.6 (18) | 0.014 |
Cardioembolism | 51.6 (47) | 70.6 (72) | 0.007 |
Small vessel occlusion | 0 | 0 | N/A |
Stroke of other determined aetiology | 0.0 (0) | 1.0 (1) | 1.000 |
Stroke of undetermined aetiology | 15.4 (14) | 2.0 10.8 (11) | 0.342 |
Site of occlusion, % (n) | |||
M1-MCA | 48.9 (46) | 49.0 (51) | 0.989 |
M2-MCA | 9.6 (9) | 6.7 (7) | 0.463 |
M3-MCA | 3.2 (3) | 2.9 (3) | 1.000 |
Carotid T | 16.0 (15) | 22.1 (23) | 0.272 |
Tandem | 11.7 (11) | 8.7 (9) | 0.477 |
Basilar artery | 8.5 (8) | 9.6 (10) | 0.787 |
Multi-vessel | 2.1 (2) | 1.0 (1) | 0.605 |
Procedure timings | |||
Time from onset to arrival (min), median (IQR) | 85 (42–184) | 73 (38–177) | 0.355 |
Time from door to imaging (min), median (IQR) | 1 (0–12) | 2 (0–13) | 0.580 |
Time from door to needle (min), median (IQR) | 48 (40–57) | 49 (42–59) | 0.560 |
Time from onset to puncture (min), median (IQR) | 214 (165–308) | 210 (161–310) | 0.897 |
Time taken for clot retrieval (min), median (IQR) | 35 (21–58) | 35 (20–60) | 0.889 |
Bridging thrombolysis, % (n) | 62.8 (59) | 57.7 (60) | 0.467 |
Laboratory findings, mean (SD) | |||
Creatinine (μmol/l) | 94.3 (105.1) | 111.5 (81.2) | 0.198 |
Haemoglobin (g/dl) | 13.0 (1.7) | 12.2 (2.2) | 0.005 |
Albumin (g/l) | 34.0 (4.0) | 32.3 (4.6) | 0.018 |
Outcomes | |||
Outcomes in hospital | |||
Duration of hospitalisation (days), median (IQR) | 15 (8–28) | 15 (8–24) | 0.539 |
In-hospital mortality, % (n) | 9.6 (9) | 18.3 (19) | 0.080 |
Carer required, % (n) | 72.8 (59) | 91.6 (76) | 0.002 |
mRS at 3 months, % (n) | |||
0 | 14.9 (14) | 4.8 (5) | 0.016 |
1 | 8.5 (8) | 3.8 (4) | 0.170 |
2 | 7.4 (7) | 7.7 (8) | 0.948 |
3 | 21.3 (20) | 14.4 (15) | 0.207 |
4 | 25.5 (24) | 29.8 (31) | 0.502 |
5 | 9.6 (9) | 16.3 (17) | 0.159 |
6 | 12.8 (12) | 23.1 (24) | 0.060 |
Stroke outcomes | |||
Functional independence at 3 months (mRS 0–2), % (n) | 30.9 (29) | 16.3 (17) | 0.016 |
Successful reperfusion (mTICI ≥2b), % (n) | 87.8 (79) | 80.0 (80) | 0.147 |
Symptomatic ICH, % (n) | 5.3 (5) | 2.9 (3) | 0.481 |
Haemorrhagic transformation, % (n) | 26.1 (24) | 29.7 (30) | 0.576 |
Abbreviations: CFS, Clinical Frailty Scale; ICH, intracerebral haemorrhage; IQR, interquartile range; MCA, middle cerebral artery; mRS, Modified Rankin Score; mTICI, Modified Treatment in Cerebral Infarction; NIHSS, National Institutes of Health Stroke Scale; SD, standard deviation; TIA, transient ischaemic attack; TOAST, Trial of Org 10,172 in Acute Stroke Treatment.
Bold: p < 0.05.
Characteristics of frail and non-frail older acute ischaemic stroke patients that underwent endovascular thrombectomy
Variable . | Not frail (CFS 1–3) n = 94 . | Frail (CFS > 3) n = 104 . | P value . |
---|---|---|---|
Baseline characteristics and investigations | |||
Age (years), mean (SD) | 75.7 (4.3) | 80.4 (5.9) | <0.001 |
Female, % (n) | 41.5 (39) | 61.5 (64) | 0.005 |
Race, % (n) | |||
Chinese | 80.9 (76) | 69.2 (72) | 0.240 |
Malay | 10.6 (10) | 22.1 (23) | 0.120 |
Indian | 5.3 (5) | 6.7 (7) | 1.000 |
Others | 3.2 (3) | 1.9 (2) | 1.000 |
Co-morbidities | |||
Hypertension, % (n) | 77.7 (73) | 90.4 (94) | 0.014 |
Diabetes mellitus, % (n) | 30.9 (29) | 35.6 (37) | 0.481 |
Dyslipidaemia, % (n) | 64.9 (61) | 70.2 (73) | 0.426 |
Ischaemic heart disease, % (n) | 25.5 (24) | 26.9 (28) | 0.824 |
Smoking, % (n) | 6.4 (6) | 1.9 (2) | 0.153 |
Atrial fibrillation, % (n) | 52.1 (49) | 71.2 (74) | 0.006 |
Previous stroke/TIA, % (n) | 8.6 (8) | 21.2 (22) | 0.014 |
Cognitive impairment, % (n) | 4.3 (4) | 18.3 (19) | 0.002 |
NIHSS on arrival, median (IQR) | 18 (13–23) | 20 (16–23) | 1.000 |
TOAST, % (n) | |||
Large artery atherosclerosis | 33.0 (30) | 17.6 (18) | 0.014 |
Cardioembolism | 51.6 (47) | 70.6 (72) | 0.007 |
Small vessel occlusion | 0 | 0 | N/A |
Stroke of other determined aetiology | 0.0 (0) | 1.0 (1) | 1.000 |
Stroke of undetermined aetiology | 15.4 (14) | 2.0 10.8 (11) | 0.342 |
Site of occlusion, % (n) | |||
M1-MCA | 48.9 (46) | 49.0 (51) | 0.989 |
M2-MCA | 9.6 (9) | 6.7 (7) | 0.463 |
M3-MCA | 3.2 (3) | 2.9 (3) | 1.000 |
Carotid T | 16.0 (15) | 22.1 (23) | 0.272 |
Tandem | 11.7 (11) | 8.7 (9) | 0.477 |
Basilar artery | 8.5 (8) | 9.6 (10) | 0.787 |
Multi-vessel | 2.1 (2) | 1.0 (1) | 0.605 |
Procedure timings | |||
Time from onset to arrival (min), median (IQR) | 85 (42–184) | 73 (38–177) | 0.355 |
Time from door to imaging (min), median (IQR) | 1 (0–12) | 2 (0–13) | 0.580 |
Time from door to needle (min), median (IQR) | 48 (40–57) | 49 (42–59) | 0.560 |
Time from onset to puncture (min), median (IQR) | 214 (165–308) | 210 (161–310) | 0.897 |
Time taken for clot retrieval (min), median (IQR) | 35 (21–58) | 35 (20–60) | 0.889 |
Bridging thrombolysis, % (n) | 62.8 (59) | 57.7 (60) | 0.467 |
Laboratory findings, mean (SD) | |||
Creatinine (μmol/l) | 94.3 (105.1) | 111.5 (81.2) | 0.198 |
Haemoglobin (g/dl) | 13.0 (1.7) | 12.2 (2.2) | 0.005 |
Albumin (g/l) | 34.0 (4.0) | 32.3 (4.6) | 0.018 |
Outcomes | |||
Outcomes in hospital | |||
Duration of hospitalisation (days), median (IQR) | 15 (8–28) | 15 (8–24) | 0.539 |
In-hospital mortality, % (n) | 9.6 (9) | 18.3 (19) | 0.080 |
Carer required, % (n) | 72.8 (59) | 91.6 (76) | 0.002 |
mRS at 3 months, % (n) | |||
0 | 14.9 (14) | 4.8 (5) | 0.016 |
1 | 8.5 (8) | 3.8 (4) | 0.170 |
2 | 7.4 (7) | 7.7 (8) | 0.948 |
3 | 21.3 (20) | 14.4 (15) | 0.207 |
4 | 25.5 (24) | 29.8 (31) | 0.502 |
5 | 9.6 (9) | 16.3 (17) | 0.159 |
6 | 12.8 (12) | 23.1 (24) | 0.060 |
Stroke outcomes | |||
Functional independence at 3 months (mRS 0–2), % (n) | 30.9 (29) | 16.3 (17) | 0.016 |
Successful reperfusion (mTICI ≥2b), % (n) | 87.8 (79) | 80.0 (80) | 0.147 |
Symptomatic ICH, % (n) | 5.3 (5) | 2.9 (3) | 0.481 |
Haemorrhagic transformation, % (n) | 26.1 (24) | 29.7 (30) | 0.576 |
Variable . | Not frail (CFS 1–3) n = 94 . | Frail (CFS > 3) n = 104 . | P value . |
---|---|---|---|
Baseline characteristics and investigations | |||
Age (years), mean (SD) | 75.7 (4.3) | 80.4 (5.9) | <0.001 |
Female, % (n) | 41.5 (39) | 61.5 (64) | 0.005 |
Race, % (n) | |||
Chinese | 80.9 (76) | 69.2 (72) | 0.240 |
Malay | 10.6 (10) | 22.1 (23) | 0.120 |
Indian | 5.3 (5) | 6.7 (7) | 1.000 |
Others | 3.2 (3) | 1.9 (2) | 1.000 |
Co-morbidities | |||
Hypertension, % (n) | 77.7 (73) | 90.4 (94) | 0.014 |
Diabetes mellitus, % (n) | 30.9 (29) | 35.6 (37) | 0.481 |
Dyslipidaemia, % (n) | 64.9 (61) | 70.2 (73) | 0.426 |
Ischaemic heart disease, % (n) | 25.5 (24) | 26.9 (28) | 0.824 |
Smoking, % (n) | 6.4 (6) | 1.9 (2) | 0.153 |
Atrial fibrillation, % (n) | 52.1 (49) | 71.2 (74) | 0.006 |
Previous stroke/TIA, % (n) | 8.6 (8) | 21.2 (22) | 0.014 |
Cognitive impairment, % (n) | 4.3 (4) | 18.3 (19) | 0.002 |
NIHSS on arrival, median (IQR) | 18 (13–23) | 20 (16–23) | 1.000 |
TOAST, % (n) | |||
Large artery atherosclerosis | 33.0 (30) | 17.6 (18) | 0.014 |
Cardioembolism | 51.6 (47) | 70.6 (72) | 0.007 |
Small vessel occlusion | 0 | 0 | N/A |
Stroke of other determined aetiology | 0.0 (0) | 1.0 (1) | 1.000 |
Stroke of undetermined aetiology | 15.4 (14) | 2.0 10.8 (11) | 0.342 |
Site of occlusion, % (n) | |||
M1-MCA | 48.9 (46) | 49.0 (51) | 0.989 |
M2-MCA | 9.6 (9) | 6.7 (7) | 0.463 |
M3-MCA | 3.2 (3) | 2.9 (3) | 1.000 |
Carotid T | 16.0 (15) | 22.1 (23) | 0.272 |
Tandem | 11.7 (11) | 8.7 (9) | 0.477 |
Basilar artery | 8.5 (8) | 9.6 (10) | 0.787 |
Multi-vessel | 2.1 (2) | 1.0 (1) | 0.605 |
Procedure timings | |||
Time from onset to arrival (min), median (IQR) | 85 (42–184) | 73 (38–177) | 0.355 |
Time from door to imaging (min), median (IQR) | 1 (0–12) | 2 (0–13) | 0.580 |
Time from door to needle (min), median (IQR) | 48 (40–57) | 49 (42–59) | 0.560 |
Time from onset to puncture (min), median (IQR) | 214 (165–308) | 210 (161–310) | 0.897 |
Time taken for clot retrieval (min), median (IQR) | 35 (21–58) | 35 (20–60) | 0.889 |
Bridging thrombolysis, % (n) | 62.8 (59) | 57.7 (60) | 0.467 |
Laboratory findings, mean (SD) | |||
Creatinine (μmol/l) | 94.3 (105.1) | 111.5 (81.2) | 0.198 |
Haemoglobin (g/dl) | 13.0 (1.7) | 12.2 (2.2) | 0.005 |
Albumin (g/l) | 34.0 (4.0) | 32.3 (4.6) | 0.018 |
Outcomes | |||
Outcomes in hospital | |||
Duration of hospitalisation (days), median (IQR) | 15 (8–28) | 15 (8–24) | 0.539 |
In-hospital mortality, % (n) | 9.6 (9) | 18.3 (19) | 0.080 |
Carer required, % (n) | 72.8 (59) | 91.6 (76) | 0.002 |
mRS at 3 months, % (n) | |||
0 | 14.9 (14) | 4.8 (5) | 0.016 |
1 | 8.5 (8) | 3.8 (4) | 0.170 |
2 | 7.4 (7) | 7.7 (8) | 0.948 |
3 | 21.3 (20) | 14.4 (15) | 0.207 |
4 | 25.5 (24) | 29.8 (31) | 0.502 |
5 | 9.6 (9) | 16.3 (17) | 0.159 |
6 | 12.8 (12) | 23.1 (24) | 0.060 |
Stroke outcomes | |||
Functional independence at 3 months (mRS 0–2), % (n) | 30.9 (29) | 16.3 (17) | 0.016 |
Successful reperfusion (mTICI ≥2b), % (n) | 87.8 (79) | 80.0 (80) | 0.147 |
Symptomatic ICH, % (n) | 5.3 (5) | 2.9 (3) | 0.481 |
Haemorrhagic transformation, % (n) | 26.1 (24) | 29.7 (30) | 0.576 |
Abbreviations: CFS, Clinical Frailty Scale; ICH, intracerebral haemorrhage; IQR, interquartile range; MCA, middle cerebral artery; mRS, Modified Rankin Score; mTICI, Modified Treatment in Cerebral Infarction; NIHSS, National Institutes of Health Stroke Scale; SD, standard deviation; TIA, transient ischaemic attack; TOAST, Trial of Org 10,172 in Acute Stroke Treatment.
Bold: p < 0.05.
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