Development and internal validation of a nomogram for predicting 90-day poor functional outcome after mechanical thrombectomy in very elderly patients: A retrospective cohort study.
Nomogram predicted 90-day poor outcome after thrombectomy in patients 80 and older
Development and internal validation of a nomogram for predicting 90-day poor functional outcome after mechanical thrombectomy in very elderly patients: A retrospective cohort study.
Mechanical thrombectomy (mechanical thrombectomy) is increasingly performed in very elderly patients with acute ischemic stroke, but individualized in-hospital prognostic assessment after treatment remains limited, particularly after early postprocedural events have become clinically apparent.
This study aimed to develop and internally validate a nomogram for predicting 90-day poor functional outcomes in very elderly patients after mechanical thrombectomy.
We retrospectively enrolled very elderly patients (aged ≥ 80 years) with acute ischemic stroke who underwent mechanical thrombectomy at a single center between January 1, 2020 and August 1, 2025.
AUROC 0.874, 1.0 is perfect, model reliably separates poor from good outcomes
The final nomogram incorporated 6 predictors: National Institutes of Health Stroke Scale score at admission, diabetes mellitus, puncture-to-recanalization time, postoperative pneumonia, symptomatic intracranial hemorrhage (sICH), and poor collateral status.
Calibration was acceptable, with a Brier score of 0.112, a calibration intercept of 0.057, and a calibration slope of 1.090.
Decision curve analysis demonstrated a meaningful net benefit across threshold probabilities ranging from 0.01 to 0.99.
This model may assist in-hospital prognostic stratification, risk communication, and discharge planning in already treated patients after early postprocedural complications have been identified or excluded.