Evidence mapPaperPMID 41965254Full record

SynthesisAge and ageing2026

Treatment-modifying effects of frailty on stroke reperfusion therapy outcomes: a systematic review and meta-analysis.

Anakha Varma, Shiv Bhakta, Esmee Dohle, Elizabeth Warburton, Nicholas R Evans

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Age and ageing, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Anakha VarmaDepartment of Clinical Neurosciences, University of Cambridge, Cambridge, England, United Kingdom of Great Britain and Northern Ireland.
Shiv BhaktaDepartment of Clinical Neurosciences, University of Cambridge, Cambridge, England, United Kingdom of Great Britain and Northern Ireland.
Esmee DohleDepartment of Clinical Neurosciences, University of Cambridge, Cambridge, England, United Kingdom of Great Britain and Northern Ireland.ORCID 0000-0002-5385-2026
Elizabeth WarburtonDepartment of Clinical Neurosciences, University of Cambridge, Cambridge, England, United Kingdom of Great Britain and Northern Ireland.
Nicholas R EvansDepartment of Clinical Neurosciences, University of Cambridge, Cambridge, England, United Kingdom of Great Britain and Northern Ireland.ORCID 0000-0002-7640-4701

Funding

NIHR Cambridge Biomedical Research Centre NIHR203312Research Training Fellowship from The Vivensa Foundation JBGS22\20Stroke Association PG2S21\100018Stroke Association Senior Clinical Lectureship SA-SCL-MED-22\100006
6 · The paper itself

Abstract

backgroundFrailty is common amongst individuals presenting with acute ischaemic stroke (AIS). Not only has frailty been found to have disease-modifying effects in terms of survival and disability after AIS, but it may also exert a treatment-modifying effect in reperfusion therapies. However, studies investigating this to date have frequently been of limited sample size, highlighting the potential for meta-analysis to definitively establish any treatment-modifying effect.

objectivesWe investigate the effect of pre-stroke frailty on morbidity and mortality outcomes following reperfusion treatment (thrombectomy and thrombolysis) for AIS.

methodsA systematic review was performed according to Preferred Reporting of Items in Systematic Reviews and Meta-Analyses guidelines, via searching the EMBASE, PubMed, Scopus and Web of Science databases up to August 2025.

resultsWe identified 11 relevant studies with 194,699 participants. Overall, the prevalence of frailty was 37.2% [frail (n = 72,311), non-frail (122,096)]. Frailty was associated with increased 90-day (RR 2.19 [95% CI 1.44-3.34]) and one-year mortality (RR 2.11 [95% CI 1.6-2.78]), but not with symptomatic intracranial haemorrhage (RR 1.23 [95% CI 0.78-1.96]) or modified Rankin score 3-5 (RR 2.20 [0.94-5.16]).

conclusionsFrailty has a consistent association with mortality at different time points after AIS reperfusion therapies. Despite some study heterogeneity, there is evidence that pre-stroke frailty is associated with increased mortality after treatment, though not with increased risks of symptomatic intracerebral haemorrhage or post-stroke disability. These findings suggest that routine pre-morbid frailty assessment may inform the decision-making process for AIS reperfusion treatment administration. This study highlights the need for large multi-centre prospective trials.

Indexed as

FrailtyIschemic StrokeReperfusionThrombectomyThrombolytic TherapyHumansTreatment Outcomeacute ischaemic strokefrailtyolder peopleoutcomessystematic reviewthrombectomythrombolysis

Identifiers

PMID41965254
PMCPMC13070556

What Socratic holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.