Aims: To investigate the difference in baseline clinical/radiological characteristics and outcomes between acute ischaemic patients≤40 years and >40 years who received endovascular thrombectomy (EVT) or non-EVT, respectively.
Method: Data was sourced from acute ischaemic stroke patients with anterior circulation stroke from the International Stroke Perfusion Imaging Registry (INSPIRE). Regression model was performed to assess the predictive power of age ≤40 years and baseline core volume on clinical outcomes for patients who received EVT and non-EVT, respectively.
Results: 1596 patients were included in the EVT and 1076 in the non-EVT cohort. 5.7% (91/1596) of the patients in the EVT cohort and 7.2% (77/1076) of the patients in the non-EVT cohort were ≤40 years. Patients ≤40 years had fewer risk factors than those >40 years in both EVT and non-EVT cohorts. Patients ≤40 years had a higher chance of achieving good outcomes than those >40 years (72.53% vs. 47.24%, aOR: 3.53, 95%CI:1.74-7.18, P=0.001) in the EVT cohort. Similar results were observed in the non-EVT cohort (achieving mRS 0-2, 80.93% vs. 55.86%, aOR: 12.72, 95%CI: 2.53,63.79, P=0.001). Increased core volume did not reduce the clinical benefit of EVT in patients ≤40 years, particularly in patients with a large core (>50ml) (OR for achieving mRS 0-2 10.14, 95% CI: 2.39-42.98, P=0.002).
Conclusion:
In comparison to patients aged >40 years, those ≤40 years had a more favourable prognosis, regardless of whether EVT treatment was performed or not. In patients undergoing EVT with large core, those ≤40 years had better clinical outcomes than those >40 years.