ArticleHealthcare (Basel, Switzerland)2026
Real-World Outcomes of Ischemic Stroke Interventions in Older Patients: A Cohort Study from a Tertiary Medical Center.
Article in Healthcare (Basel, Switzerland), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundEvidence regarding optimal reperfusion strategies in older patients with acute ischemic stroke remains inconsistent, particularly in real-world settings where patient selection and comorbidity burden differ from randomized trials.
objectiveThis study evaluates real-world outcomes of ischemic stroke interventions among older adults in a tertiary medical center.
methodsThis single-center retrospective cohort study included patients aged ≥ 65 years with acute ischemic stroke admitted between August 2022 and December 2023. Mortality follow-up continued until September 2024. Patients were categorized according to treatment: intravenous thrombolysis (tPA) alone, endovascular thrombectomy (EVT) alone, or combined (tPA + EVT) therapy. Data included demographics, comorbidities, stroke severity (NIHSS), imaging, treatment timing, and mortality outcomes.
resultsAmong 200 patients (mean age 77.5 years), 66 received tPA, 86 underwent EVT, and 48 received tPA + EVT therapy. Patients treated with tPA alone presented with milder strokes and had low in-hospital and six-month mortality (1.5% and 6.1%, respectively). In contrast, EVT-only patients had substantially higher in-hospital and six-month mortality (21% and 43%, respectively). Patients receiving tPA + EVT therapy had low mortality rates comparable to the tPA group (2.1% and 6.3%, respectively), despite greater stroke severity at presentation.
conclusionsDespite greater stroke severity, patients receiving tPA + EVT therapy had outcomes comparable to those treated with tPA alone, while EVT-only patients experienced substantially higher mortality. These findings underscore the importance of patient selection and suggest that treatment allocation may strongly influence real-world outcomes in older adults.
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