Stroke incidence in the young: evidence from a Norwegian register study

Abstract

IntroductionWhile there is a general agreement that stroke incidence among the elderly is declining in the developed world, there is a concern that it may be increasing among the young. The present study investigates this issue for the Norwegian population for the years 2010–2015. Cerebrovascular accidents (CVAs) for patients younger than 55 years were identified through the Norwegian Patient Registry and the Norwegian Cause-of-death Registry.MethodsNegative binomial regression modelling was used to estimate temporal trends in the CVA incidence rates for the young, aged 15–54, with 10-year sub-intervals, and for children below the age of 18. The main outcomes were CVA incidence per 100,000 person-years at risk (PY), 30-day stroke mortality per 100,000 PY, and 30-day case-fatality rates.ResultsThe analysis showed a negative and non-significant temporal trend in the CVA incidence () as well as for 30-day mortality () for the age group 15–54. Overall, the inclusion of an interaction for age in the bracket 45–54 suggested that any temporal decline is restricted to this age bracket. The analyses of the 10-year age brackets 15–24, 25–34, and 34–45, provided evidence neither for an increase, nor for a decrease, in incidence. Among the children, the estimated temporal coefficients were positive, but non-significant, consistent with a stationary trend.ConclusionWeak statistical evidence was found for a decline in CVA incidence and for overall stroke 30-day case fatality for 15–54 year olds, but the decline was significant only for the 45–54 age band. All results considered, the study suggests a stationary or decreasing temporal trend in CVA incidence and stroke fatality for children (0–18) and young (15–54) in Norway. Even larger data sets are needed to estimate these temporal trends accurately.

Young ischaemic stroke incidence and demographic characteristics – The Norwegian stroke in the young study – A three-generation research program

“…[1][2][3][4][5][6][7][8] However, a recent Norwegian registry study from 2010 to 2015 reported that the stroke incidence was stationary across patients aged 15-44 years and declining across patients aged 45-54. 24 This study reported annual incidence rate as 20.7 per 100,000 across patients aged 15-49 years, higher than in our prospective, clinical study, and a decline of stroke incidence in the period 2010-2015 for patients aged 15-54 years. We expect, however, that the results of the national registry study are in line with our results as methods are different, and our ischaemic stroke diagnosis was solely based on clinical and radiological documentation with MRI performed for 98.5% of our patients.…”

High incidence of stroke in young adults in Tartu, Estonia, 2013 to 2017: A prospective population‐based study

“…In the 15‐ to 44‐year‐old age group of IS patients, we reported one death (2.6%). Our case fatality rates are higher than reported from a retrospective study based on administrative data from Norway, where they estimated all stroke 30‐day case fatality in 15‐ to 54‐year‐old patients at 4.5%, ranging from 1.8% for ischemic to 15.7% for hemorrhagic strokes [40]. We registered three deaths among patients with IS.…”

Fewer ischemic strokes, despite an ageing population: stroke models from observed incidence in Norway 2010–2015

“…Note that the model for children does not include any terms for time trend. The child model is based on a separate, comprehensive study of strokes in the young, which concludes that there is no observable time trend for this group [22].…”