To investigate the influence of demographic, clinical, and social factors on long-term functional outcomes in patients undergoing mechanical thrombectomy.

Mechanical thrombectomy has become standard-of-care in the treatment of emergent large vessel occlusion. However, it is not yet known if social factors impact post-thrombectomy recovery. We studied the association between clinical and sociodemographic factors with 3-month functional outcomes post thrombectomy.

In this prospective cohort study, 291 patients who underwent mechanical thrombectomy at Montefiore-Einstein Hospital in NYC between 1/1/2021 and 4/1/2024 were analyzed. The cohort spanned multiple census tracts across New York City and surrounding areas and included a diverse patient population. The primary outcome was change in modified Rankin Scale (ΔmRS) from pre-stroke baseline to 90–180 days post-stroke. Ordinal logistic regression was used to assess the relationship between ΔmRS and social vulnerability, adjusting for age, sex, stroke severity, and procedural success.

Worse functional outcomes were associated with older age (OR 1.03; p = 0.004), male sex (OR 1.85; p = 0.006), higher stroke severity (OR 1.71; p < 0.001), and lower reperfusion success (OR 2.22; p = 0.011). Social vulnerability was not significantly associated with long-term outcomes (OR 0.88; p = 0.550).

In this cohort, functional outcomes after mechanical thrombectomy were influenced by clinical and procedural factors rather than sociodemographic vulnerability. While equitable outcomes were observed in the acute setting, ongoing research is needed to explore potential disparities across the broader stroke care continuum, including post-acute recovery.