Stroke in Young Adults in Spain: Epidemiology and Risk Factors by Age

Pascasio, Laura Amaya; Blanco-Ruiz, Marina; Pinilla, Rodrigo Milán; García-Torrecillas, Juan Manuel; Padillo, Antonio Arjona; Pérez, Cristina Del Toro; Martínez-Sánchez, Patricia

doi:10.3390/jpm13050768

Cited by 4 publications

(2 citation statements)

References 34 publications

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“…In a Ludhiana population-based study, DLP was observed in 15% of young strokes [ 5 ]. Various studies from European countries reported DLP rates ranging from 26.4% to 52.7% [ 10 , 11 , 14 ]. Our study reports a lower frequency of smoking as compared to the data from the Western world [ 11 , 15 ].…”

Section: Discussionmentioning

confidence: 99%

“…Real-time TEE in patients with normal TEE can help in reclassifying patients in the undermined category by increasing the yield of the pick rate of the left ventricle (LV), left atrial (LA) clots, and PFO. Western literature reports PFO and atrial septal aneurysm (ASA) as the most common aetiologies behind cardioembolic strokes [ 14 , 20 ].…”

Section: Discussionmentioning

confidence: 99%

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Risk Factors and Stroke Subtyping in Young Adults: A Study From a Tertiary Care Hospital in South India

Shivde,

Badachi,

Deepalam

et al. 2024

Cureus

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Objectives: This study aimed to determine the risk factors and stroke subtypes for young ischemic stroke patients and their outcomes at the time of discharge. Methods: This is a retrospective cross-sectional study of ischemic stroke patients (n = 264) between the age groups of 18 and 45. The study population was divided into two broad age groups: 18 to 35 years and 36 to 45 years; and compared based on demographics, risk factors, the Trial of Org 10172 in Acute Stroke Treatment (TOAST) classification, and outcomes. The outcomes were compared based on the National Institutes of Health Stroke Scale (NIHSS) and Modified Rankin Scale (MRS) systems at the time of admission and discharge. Results: The mean age of patients was 37.84±6.19 years. The male-to-female ratio was 2.5:1. The most common vascular risk factors identified were diabetes (29.16%), hypertension (49.62%), dyslipidaemia (DLP, 44.4%), and smoking (10.9%). The most common TOAST subtype was large vessel disease (38.63%), followed by the undetermined category (35.6%). The elderly group showed a high proportion of strokes secondary to small vessel disease (14.13%; p = 0.03), while cardioembolic strokes were common in the female subgroup (p = 0.05). The majority of strokes were in the anterior circulation (66.6%) as compared to the posterior (25.75%), and nearly 50% of the patients had intracranial disease. Overall, there was a favourable MRS outcome at discharge. Conclusion: Conventional vascular risk factors are equally prevalent, even among young stroke patients. The benchmark for young stroke age is showing a downward shift as more stroke patients above the age of 35 are showing similar risk factor trends as those of their older counterparts. The majority of stroke burden still falls under the undermined category, which requires aggressive risk factor identification and management.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Risk Factors and Stroke Subtyping in Young Adults: A Study From a Tertiary Care Hospital in South India

Shivde,

Badachi,

Deepalam

et al. 2024

Cureus

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Predictors of social risk for post-ischemic stroke reintegration

Cisek,

Nguyen,

Garcia-Rudolph

et al. 2024

Sci Rep

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After stroke rehabilitation, patients need to reintegrate back into their daily life, workplace and society. Reintegration involves complex processes depending on age, sex, stroke severity, cognitive, physical, as well as socioeconomic factors that impact long-term outcomes post-stroke. Moreover, post-stroke quality of life can be impacted by social risks of inadequate family, social, economic, housing and other supports needed by the patients. Social risks and barriers to successful reintegration are poorly understood yet critical for informing clinical or social interventions. Therefore, the aim of this work is to predict social risk at rehabilitation discharge using sociodemographic and clinical variables at rehabilitation admission and identify factors that contribute to this risk. A Gradient Boosting modelling methodology based on decision trees was applied to a Catalan 217-patient cohort of mostly young (mean age 52.7), male (66.4%), ischemic stroke survivors. The modelling task was to predict an individual’s social risk upon discharge from rehabilitation based on 16 different demographic, diagnostic and social risk variables (family support, social support, economic status, cohabitation and home accessibility at admission). To correct for imbalance in patient sample numbers with high and low-risk levels (prediction target), five different datasets were prepared by varying the data subsampling methodology. For each of the five datasets a prediction model was trained and the analysis involves a comparison across these models. The training and validation results indicated that the models corrected for prediction target imbalance have similarly good performance (AUC 0.831–0.843) and validation (AUC 0.881 - 0.909). Furthermore, predictor variable importance ranked social support and economic status as the most important variables with the greatest contribution to social risk prediction, however, sex and age had a lesser, but still important, contribution. Due to the complex and multifactorial nature of social risk, factors in combination, including social support and economic status, drive social risk for individuals.

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Atrial fibrillation in young stroke patients: Associated factors and outcomes in a nationwide analysis

Garrido‐Hernández,

Amaya‐Pascasio,

Quesada‐López

et al. 2024

Euro J of Neurology

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Background and purposeKnowledge about the prevalence of atrial fibrillation (AF) in young stroke patients, as well as its associated factors and outcomes, is scarce. Our objective was to analyse it.MethodsA retrospective analysis of the Spain Nationwide Minimum Basic Data Set (MBDS) (2016–2020), including ischaemic stroke (IS) patients aged 18 and 50 years, was conducted. Multivariate analyses were conducted to identify factors related to AF diagnosis.ResultsAmongst 11,615 young IS patients, 426 (3.7%) had AF. Patients with AF were older (median age 45, interquartile range 42–48 vs. 44, interquartile range 40–47 years, p < 0.001) and displayed more incapacitating symptoms, higher in‐hospital complications and were less often discharged home (p < 0.001). Multivariate analyses showed that older age (odds ratio [OR] 1.053, 95% confidence interval [CI] 1.032–1.074), obstructive sleep apnoea (OR 1.508, 95% CI 1.018–2.233), hyperthyroidism (OR 3.741, 95% CI 1.798–7.783), valvular heart disease (OR 6.094, 95% CI 4.261–8.716), congenital (OR 2.386, 95% CI 1.146–4.969) and non‐congenital (OR 4.446, 95% CI 3.149–6.278) cardiopathies and heart failure (OR 3.098, 95% CI 1.905–5.037) were independently associated with higher probability of AF, whereas female gender (OR 0.647, 95% CI 0.516–0.812), diabetes mellitus (0.487, 95% CI 0.339–0.699), smoking (OR 0.617, 95% CI 0.501–0.759), patent foramen ovale (OR 0.210, 95% CI 0.111–0.396) and arterial dissection (OR 0.294, 95% CI 0.130–0.668) were associated with a lower probability.ConclusionsIn young IS patients, AF is associated with more in‐hospital complications and disabling strokes. These findings emphasize the need to recognize AF in this demographic group, especially in patients with risk factors like hyperthyroidism and cardiomyopathies. Clinicians should assess these risk factors to ensure timely diagnosis and management of AF.

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Stroke in Young Adults in Spain: Epidemiology and Risk Factors by Age

Cited by 4 publications

References 34 publications

Risk Factors and Stroke Subtyping in Young Adults: A Study From a Tertiary Care Hospital in South India

Risk Factors and Stroke Subtyping in Young Adults: A Study From a Tertiary Care Hospital in South India

Predictors of social risk for post-ischemic stroke reintegration

Atrial fibrillation in young stroke patients: Associated factors and outcomes in a nationwide analysis

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