Key result
Higher admission eGFR linked to ~47% higher odds of favorable 90-day post-thrombectomy outcome per 10 mL/min.
Why the study?
A single admission eGFR does not establish chronic kidney disease, and its association with 90-day outcomes after mechanical thrombectomy warranted evaluation using verified patient-level data and bias-reduced regression.
Does higher admission eGFR improve 90-day functional outcomes (mRS 0–2) in adults undergoing mechanical thrombectomy for anterior-circulation large-vessel occlusion stroke?
Cohort (n=125)
No
Does higher admission eGFR improve 90-day functional outcomes (mRS 0–2) in adults undergoing mechanical thrombectomy for anterior-circulation large-vessel occlusion stroke?
Odds Ratio: 1.47 (95% CI 1.17–1.86)
In patients undergoing mechanical thrombectomy for anterior-circulation large-vessel occlusion stroke, higher admission eGFR is independently associated with better 90-day functional outcomes and lower odds of symptomatic intracranial hemorrhage and early neurological deterioration.
Admission eGFR may aid 90-day risk stratification after MT; leaves open whether it identifies modifiable targets or alters selection.
Background A single admission estimated glomerular filtration rate (eGFR) may provide prognostic information after mechanical thrombectomy (MT), but it does not establish chronic kidney disease. We evaluated the association between admission eGFR and 90-day outcomes after MT using verified patient-level data and bias-reduced regression. Methods We retrospectively studied 125 adults with anterior-circulation large-vessel occlusion treated with MT between January 2015 and May 2020. eGFR was calculated from preprocedural creatinine, age, and sex using the 2009 CKD-EPI creatinine equation without a race coefficient. Reduced admission eGFR was defined as <60 mL/min/1.73 m 2 . The primary outcome was modified Rankin Scale (mRS) 0–2 at 90 days. Firth logistic regression estimated associations per 10-mL/min/1.73 m 2 higher eGFR after adjustment for age, sex, baseline NIHSS, ASPECTS, and number of thrombectomy passes. Restricted cubic splines, propensity-score matching, sensitivity analyses, and bootstrap internal validation were used to assess robustness. Results Twenty-seven patients (21.6%) had reduced admission eGFR. Mean admission eGFR was 76.8 ± 20.8 mL/min/1.73 m 2 . Favorable 90-day outcome occurred in 68 patients (54.4%), symptomatic intracranial hemorrhage (sICH) in 18 (14.4%), early neurological deterioration in 30 (24.0%), and death in 18 (14.4%). Per 10-mL/min/1.73 m 2 higher eGFR, adjusted odds were higher for favorable outcome (OR 1.47, 95% CI 1.17–1.86) and lower for sICH (OR 0.71, 95% CI 0.54–0.94) and early neurological deterioration (OR 0.72, 95% CI 0.56–0.91). The mortality estimate was imprecise (OR 0.88, 95% CI 0.68–1.14). There was no statistical evidence of nonlinearity for favorable outcome or sICH. Conclusions Higher admission eGFR was associated with more favorable functional outcome and lower odds of sICH and early neurological deterioration in this small historical cohort. These findings are exploratory and hypothesis-generating because of sparse events, residual confounding, incomplete archival metadata, and lack of external validation.
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Li et al. (2026) conducted a cohort in Anterior-circulation large-vessel occlusion stroke treated with mechanical thrombectomy (n=125). Admission estimated glomerular filtration rate (per 10-mL/min/1.73 m2 higher eGFR) vs. Lower admission eGFR was evaluated on Favorable functional outcome defined as modified Rankin Scale (mRS) 0–2 at 90 days (OR 1.47, 95% CI 1.17–1.86). Each 10-mL/min/1.73 m2 higher admission eGFR was associated with higher odds of 90-day favorable functional outcome (mRS 0-2) after mechanical thrombectomy (OR 1.47; 95% CI 1.17-1.86).
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