Trends in stroke hospitalizations and associated risk factors among children and young adults, 1995–2008

George, Mary G.; Tong, Xin; Kuklina, Elena V.; Labarthe, Darwin R.

doi:10.1002/ana.22539

Cited by 264 publications

(242 citation statements)

References 19 publications

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“…[7] There is growing evidence for an increase in the incidence of stroke in young adults. [8] In the present study, higher male predominance among the acute ischemic stroke in young adults was observed. Similar findings had been reported from studies conducted in western world and in India.…”

Section: Discussionsupporting

confidence: 51%

Acute ischemic stroke in young adults-a hospital based study in North India

Baidya¹,

Tiwari²,

Usman³

2015

Int Jour of Biomed Res

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Objectives: To see the risk factors, clinical presentations and radiological profile of acute ischemic stroke in young adults in a tertiary-care hospital of North India. Methods: This study was conducted among 50 acute ischemic stroke patients (clinically and radiologically confirmed) irrespective of sex within the age group of 15-45 years admitted to Department of Medicine (Emergency Unit) after getting clearance from Institutional Ethical Committee (IEC). A proforma for each of the acute ischemic stroke patients was maintained where all clinical information in brief including particulars of the subject, chief complaints, past history, proper general physical examination and systemic examinations etc were recorded. The patients had been undergone plain CT (computed tomography) scan/MRI (Magnetic Resonance Imaging) brain on admission for radiological confirmation and to localize the site of lesion in brain. Results: Hypertension (56%) was the most common risk factor among acute ischemic stroke in young adults, followed by heart disease (54%). Majority of the acute ischemic stroke patients presented with hemiplegia (84%). Beside, imaging findings confirmed left sided brain lesion in majority of the patients (52%) and anterior circulation as the most common territory involved in the brain. Conclusions: Hypertension is very common among the young acute ischemic stroke patients. Most common clinical presentation is hemiplegia. Thus, the knowledge of the risk factors, clinical presentation and radiological findings of acute ischemic stroke in young adults can help in prevention, better understanding and therapeutic decision making in the disease management.

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Section: Discussionsupporting

confidence: 51%

Acute ischemic stroke in young adults-a hospital based study in North India

Baidya¹,

Tiwari²,

Usman³

2015

Int Jour of Biomed Res

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“…We found that younger patients were at relatively increased odds of stroke after ILI compared to older patients; for every decade younger age, the odds increased by almost 10%. While the absolute risk of stroke is greater in older adults, approximately 10–14% of all strokes occur in people 18–45 years old, with the incidence and prevalence of stroke in the young increasing 4, 28, 29, 30, 31, 32, 33, 34. This increasing prevalence, moreover, coupled with greater heterogeneity in stroke etiology within the younger age group than in the older stroke population, presents a unique and vulnerable patient population where risk reduction efforts are of increasing importance.…”

Section: Discussionmentioning

confidence: 99%

Influenza‐like illness as a trigger for ischemic stroke

Boehme

Luna

Kulick

et al. 2018

Ann Clin Transl Neurol

120

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ObjectiveWe hypothesized that ILI is associated with risk of incident stroke, and that the risk would be highest closest in time to the event.MethodsThis case‐crossover analysis utilized data obtained from the California State Inpatient Database of the Healthcare Cost and Utilization Project (HCUP). The outcome of interest was ischemic stroke. Exposure was defined as a visit to the emergency department or hospitalization for influenza‐like illness (ILI) 365, 180, 90, 30, or 15 days before stroke (risk period) or similar time intervals exactly 1 or 2 years before stroke (control period). Conditional logistic regression was used to calculate the odds ratio and 95% confidence interval (OR, 95% CI).ResultsIn 2009, 36,975 hospitalized ischemic strokes met inclusion criteria, and of these strokes, 554 (1.5%) had at least 1 episode of ILI in the 365‐day risk period prior to their stroke. Using non‐overlapping time intervals from ILI to stroke, the odds of ischemic stroke was greatest in the first 15 days post ILI (OR: 2.88, 95% CI: 1.86–4.47). The strength of the relationship decreased as the time from ILI increased, and was no longer significant after 60 days. There was a significant interaction (P = 0.017) with age and ILI; the odds of stroke associated increased 7% with each 10‐year decrease in age (OR per 10‐year age decrease 1.07, 95% CI: 1.03–1.35).InterpretationWe found that ILI increases short‐term risk of stroke, particularly in people under the age of 45, and therefore may be considered to act as a trigger for stroke.

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“…Our observed incidence rates for young strokes are similar to those in several other studies, with reported incidence rates ranging from 3 to 23 per 100 000. 9,27,28 George et al 10 have reported that ischemic stroke admissions in the United States Nationwide Inpatient Sample rose steadily from 1995 to 2008 among young adults aged 14 to 44 years, which was associated with an increase in prevalence of major risk factors such as hypertension, diabetes mellitus, and obesity. This is likely to lead to major future public health concern because stroke in younger people will influence long-term disability and result in handicap that will affect health and social care services.…”

Section: Strokementioning

confidence: 99%

“…A similar trend for stroke in young adults was also found in ischemic stroke admissions in the United States Nationwide Inpatient Sample. 10 However, most of these studies reported trends in stroke incidence in 2 or 3 different time points. 4,8,9,11 Data on continuous monitoring of stroke incidence among different ethnic groups in the same populations are lacking.…”

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confidence: 99%

Age and Ethnic Disparities in Incidence of Stroke Over Time

Wang

Rudd

Wolfe

2013

Stroke

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Background and Purpose-Data on continuous monitoring of stroke risk among different age and ethnic groups are lacking.We aimed to investigate age and ethnic disparities in stroke incidence over time from an inner-city population-based stroke register. Methods-Trends in stroke incidence and before-stroke risk factors were investigated with the South London StrokeRegister, a population-based register covering a multiethnic population of 357 308 inhabitants. Age-, ethnicity-, and sexspecific incidence rates with 95% confidence intervals were calculated, assuming a Poisson distribution and their trends over time tested by the Cochran-Armitage test. Results-Four thousand two hundred forty-five patients with first-ever stroke were registered between 1995 and 2010. Total stroke incidence reduced by 39.5% during the 16-year period from 247 to 149.5 per 100 000 population (P<0.0001). Similar declines in stroke incidence were observed in men, women, white groups, and those aged >45 years, but not in those aged 15 to 44 years (12.6-10.1; P=0.2034) and black groups (310.1-267.5; P=0.3633). The mean age at stroke decreased significantly from 71.7 to 69.6 years (P=0.0001). The reduction in prevalence of before-stroke risk factors was mostly seen in white patients aged >55 years, whereas an increase in diabetes mellitus was observed in younger black patients aged 15 to 54 years. Conclusions-Total stroke incidence decreased during the 16-year time period. However, this was not seen in younger age groups and black groups. The advances in risk factor reduction observed in white groups aged >55 years failed to be transferred to younger age groups and black groups. (Stroke. 2013;44:3298-3304.)

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Trends in stroke hospitalizations and associated risk factors among children and young adults, 1995–2008

Cited by 264 publications

References 19 publications

Acute ischemic stroke in young adults-a hospital based study in North India

Acute ischemic stroke in young adults-a hospital based study in North India

Influenza‐like illness as a trigger for ischemic stroke

Age and Ethnic Disparities in Incidence of Stroke Over Time

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