Frailty independently predicts 90-day functional independence after thrombectomy in elderly: multicenter observational study with machine learning

Retrospective multicenter study: In 674 pts >70y with EVT, frailty (CFS>3) was independently associated with lower 90d functional independence (aOR 13.45, 95% CI 2.57-70.3). Random forest AUROC 0.82; frailty top feature. External validation needed.

• Multinational observational cohort of 674 patients >70 years treated with mechanical thrombectomy for acute ischemic stroke.
• Frailty (CFS >3) showed an adjusted odds ratio of 13.45 (95% CI 2.57–70.3) for lack of 90-day functional independence, outperforming NIHSS and recanalization status.
• Random forest model achieved AUROC 0.82 (bootstrap 95% CI 0.735–0.915), but lacked external validation; frailty had the highest feature importance.

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