Preprocedural frailty status and short- and long-term mortality risk after endovascular therapy in elderly acute ischemic stroke patients

To evaluate the Laboratory-based Frailty Index (FI-LAB) for predicting mortality following endovascular therapy (EVT) in elderly patients with large vessel occlusion acute ischemic stroke (LVO-AIS). This retrospective study enrolled 382 patients aged ≥60 years undergoing EVT. FI-LAB was constructed using 44 preprocedural laboratory parameters. Primary endpoint was 12-month all-cause mortality; secondary endpoint was 14-day mortality. Cox proportional hazards models assessed FI-LAB-mortality associations. Among 382 patients, 68.8% exhibited varying degrees of frailty. In fully adjusted models, compared with robust patients, frail patients demonstrated a 1.82-fold increase in 14-day mortality risk (P = 0.012) and a 2.61-fold increase in 12-month mortality risk (P < 0.001). Each 0.1-unit increase in FI-LAB was associated with a 51% increase in 14-day mortality risk (P = 0.001) and a 63% increase in 12-month mortality risk (P < 0.001). FI-LAB independently predicts short-term and long-term mortality following EVT in elderly stroke patients, offering objective risk stratification for clinical decision-making.