Risk Factors, Etiology, and Clinical Outcome of Ischemic Stroke in Young Adults Admitted in a Tertiary Care Hospital in India

Abstract

Background: Ischemic stroke in young adults is becoming a rising concern with the increase in vulnerability to traditional risk factors and changing lifestyles. Aim: An overview of risk factors, classification, and clinical outcome of ischemic stroke in young adults (19 to 45 years) has been presented. Methods: Data fulfilling the study criteria from the stroke registry between June 2014 and June 2017 were collected, and a detailed proforma was taken that included history, clinical examination, and routine investigations. Selective investigations such as prothrombotic workup and 24-hour Holter monitoring were performed. Stroke was subclassified using the Trial of Org 10172 in Acute Stroke Treatment criteria. National Institute of Health Stroke Scale (NIHSS) scores at baseline and the modified Rankin score (mRS) scoring after 3 months of patients’ admission were calculated. Results: Out of 223 identified cases of ischemic stroke in young adults, 186 (83.4%) were taken for analysis, constituting 7.3% of the total stroke population of 3,059. Among the cases taken for analysis, 137 were males and 49 were females. A total of 150 patients were among the age group of 36 to 45 years. Dyslipidemia, smoking, and alcohol consumption were prevalent in the study group. Atherosclerotic strokes were predominant in the study population. NIHSS scores at admission had a significant impact on mRS scores after 3 months. In this study, only 4% reported the recurrence of stroke, whereas mortality was about 0.02%. Conclusions: Workup required for ischemic stroke in young adults has always been a diagnostic challenge for physicians who treat the stroke patients, and this must be optimized in all health care centers. Despite extensive workup, 23.66% participants were found to be cryptogenic in this study. The clinical outcome was good in this study with less mortality observed.

Clinical profile of patients with acute ischaemic stroke undergoing thrombolysis in a tertiary hospital- A retrospective observational study

“…In our study the mean age was 62 years which was lesser in comparison to a similar study done by Volans.P et al 14 which showed a mean age of 69 years and another study done by Werner Hacke et.al 15 that showed a mean age of 64.9 years. An Indian study done by Ramasamy et al, 16 showed mean age of 59 years which was consistent with our results.…”

Clinical and Etiological Profile of Ischemic Stroke in a Tertiary Care Hospital of Nepal

“…A study from North India revealed that the mean age of stroke patients was 39. 8 Similar multicentric study from Asian countries had mean age of 40.8. 9 This finding may be due to the study being predominantly done in the younger age group of patients.…”

The Distribution of Lifestyle Risk Factors Among Patients with Stroke in the Indian Setting: Systematic Review and Meta-Analysis

“…We have included 61 studies in our systematic review, conducted across various states in India, estimating the various lifestyle risk factors for stroke ( Table 1 ). 13 – 73 Out of 61, 56 studies were conducted and 58 were published after 2000. In 51 studies, patients were enrolled from the hospital-based stroke registries (HBSR) maintained in various treatment settings across India, while in 10 studies, the enrollment was using population-based stroke registries (PBSR).…”

“…The characteristics of the studies included in the meta-analysis are summarized in Table 2 . The meta-analysis included 36 studies, out of which two studies 31 , 66 were multicentric and the remaining included data from various states of the Indian subcontinent (North: 13, 13 , 17 , 20 , 29 , 33 , 39 , 49 , 51 , 54 – 56 , 69 , 61 South: 14, 14 , 19 , 23 , 40 , 45 , 48 , 53 , 59 , 62 , 63 , 65 , 68 , 70 , 71 East: 3, 28 , 36 , 6 West: 2, 47 , 57 and Central: 2 25 , 41 ). The majority of the studies were published in the past decade.…”

“…The majority of the studies were published in the past decade. 13 , 14 , 17 , 19 , 20 , 23 , 25 , 28 , 29 , 31 , 36 , 39 – 41 , 45 , 47 – 49 , 51 , 53 – 57 , 59 Overall, 18,315 stroke patients were included, in which the predominant proportion of subjects were males (64%) compared to females (36%). The mean age of the participants was 53.84 ± 9.3 years.…”