Abstract TMP88: Prognostic Scoring System Of Mechanical Thrombectomy For Elderly Acute Ischemic Stroke Patients

Background: The number of mechanical thrombectomy (MT) for acute ischemic stroke (AIS) in elderly patients has increased, but the feasibility and safety are still debated. We aimed to investigate the risk factors and produce a prognostic scoring system for MT in elderly AIS patients. Methods: We analyzed data from 763 consecutive patients who underwent MT for AIS between January 2013 and January 2020 at seven comprehensive stroke centers for derivation group. We defined elderly patients as ≥ 75 years of age. We investigated the risk factors of MT among these elderly patients and developed a prognostic scoring system assigned weighted points proportional to their standardized coefficient values. We conducted a subsequent validation study that included 287 consecutive patients treated between February 2020 and December 2021. Results: In total, 251 elderly patients in derivation group were analyzed retrospectively. According to the multivariable analysis, we developed a scoring system (SNA 3 P score) consisting of six factors, including age ≥ 90 (2 points), female sex (2 points), a pre-modified Rankin Scale (mRS) score of 2 (1 point), anticoagulant drug use (2 points), the NIHSS score (4 points), and the ASPECTS (4 points). A score ≤ 5 predicted an mRS score of 0-2 at 90 days with a sensitivity of 74% and a specificity of 65%, and the area under the curve (AUC) was 0.76. In the validation study, a score ≤ 5 predicted an mRS score of 0-2 at 90 days with a sensitivity of 70% and a specificity of 60% (AUC was 0.74). Conclusions: We created the novel scoring system to predict the functional outcome of elderly AIS patients undergoing MT. This simple scoring system may provide the information for indication of MT for elderly AIS patients, but further investigation for external validation is needed.