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. 2014 Dec 2;83(23):2110-5.
doi: 10.1212/WNL.0000000000001042. Epub 2014 Oct 31.

Deaths from stroke in US young adults, 1989-2009

Sharon N Poisson  1 , David Glidden  2 , S Claiborne Johnston  2 , Heather J Fullerton  2
Affiliations

Deaths from stroke in US young adults, 1989-2009

Sharon N Poisson et al. Neurology. .

Abstract

Objective: To determine what the trends in stroke mortality have been over 2 decades in young adults.

Methods: In this cohort study, we analyzed death certificate data for ischemic and hemorrhagic stroke (intracerebral hemorrhage [ICH] and subarachnoid hemorrhage [SAH]) in adults aged 20-44 in the United States for 1989 through 2009, covering approximately 2.2 billion person-years. Poisson regression was used to calculate and compare time trend data between groups and to compare trends in young adults to those in adults over age 45.

Results: Mortality from stroke in young adults declined by 35% over the study period, with reductions in all 3 stroke subtypes (ischemic stroke decreased by 15%, ICH by 47%, and SAH by 50%). Black race was a risk factor for all 3 stroke subtypes (relative risk 2.4 for ischemic stroke, 4.0 for ICH, and 2.1 for SAH), but declines in all stroke subtypes were more dramatic in black compared to white participants (p < 0.001 for all stroke subtypes).

Conclusions: Although hospitalizations for stroke in young patients have been increasing, the apparent decrease in mortality rates and in racial disparities suggests that recognition and treatment in this group may be improving.

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Figures

Figure 1
Figure 1. Time trends in stroke mortality rate by stroke subtype in US young adults
Circles represent subarachnoid hemorrhage, diamonds represent intracerebral hemorrhage, triangles represent ischemic stroke.
Figure 2
Figure 2. Percent decline in mortality rate from stroke subtypes in young adults and older adults
Green bar represents adults aged 20–44, gray bar represents adults aged 45 and older. ICH = intracerebral hemorrhage; SAH = subarachnoid hemorrhage.
Figure 3
Figure 3. Racial differences in time trends in mortality among US young adults by stroke subtype
(A) Ischemic stroke, (B) intracerebral hemorrhage, and (C) subarachnoid hemorrhage. Triangles represent black participants, diamonds represent white participants, and circles represent other.
See this image and copyright information in PMC

Comment in

References

    1. Biller J. Stroke: improving characterization of childhood cerebral arteriopathies. Nat Rev Cardiol 2009;6:395–397. - PubMed
    1. George MG, Tong X, Kuklina EV, Labarthe DR. Trends in stroke hospitalizations and associated risk factors among children and young adults, 1995–2008. Ann Neurol 2011;70:713–721. - PubMed
    1. Lehman L, Khoury J, Alwell K, et al. International stroke conference oral abstracts: Temporal trends in incidence and 30-day case fatality of pediatric stroke: a population-based study. Stroke 2010;41:e218.
    1. Nguyen-Huynh MN, Emery MH, Sidney S. Abstract 10: Rising trend of ischemic stroke in the young. Stroke 2012;43:A10.
    1. Kissela B, Alwell K, Khoury J, et al. International stroke conference oral abstracts. stroke in the young is increasing over time: temporal trends in the age of stroke incidence in a large, bi-racial population. Stroke 2010;41:e224.