Incidence of hospitalization and mortality due to stroke in young adults, residents of developed regions in Brazil, 2008-2018

Introduction We evaluated trends in hospitalization incidence and mortality due to hemorrhagic and ischemic stroke in young adults, according to gender and developed regions in Brazil. Methods Between 2008–2018, we performed a population-based time-series study using official hospitalization and death data due to stroke, in individuals aged 10–49 years, from Southeast and South, Brazil. Data were based on reports from the Unified Health System of Hospital Information System and Mortality Information System. Stroke was defined by the International Classification of Diseases, 10th revision (I60–I63). A Prais-Winsten regression model was performed and the Annual Percentage Change was calculated. Results In total, 78,123 hospitalizations of individuals aged 10–49 years were recorded, of which 59,448 (76%) resulted from hemorrhagic stroke (HS). The hospitalizations for HS was significantly decreased (- 4.37%) among men and women in both regions. The hospitalizations for ischemic stroke (IS) was flat, except between 2011 and 2018, when IS hospitalization rates increased. In the analysis by states, HS hospitalizations declined across all states, except for Espírito Santo, where it remained unchanged (p > 0.05). IS flat hospitalizations were observed in all states, except Espírito Santo, where it increased by 24.93%. In terms of mortality, 28,625 deaths were recorded, of which 26,548 (92.7%) resulted from HS. HS mortality decreased significantly by -3.48%and IS mortality by -3.84%. Decreases also occurred in all Southeast and South states (p < 0.05). IS remained unchanged across all states, except Minas Gerais, where it decreased by -14.95%. Conclusions We identified a decline in the hospitalizations and mortality of HS and a flat trend for IS in developed regions of Brazil. The recent period (2011–2018) demonstrated increasing rates in the hospitalizations of IS in both regions and genders. The mortality rates for HS and IS decreased between 2008–2018 in Southeast and South Brazil for both genders.

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Temporal Trends in the Incidence of Ischemic Stroke in Young Adults: Dijon Stroke Registry

Neuroepidemiology ◽

10.1159/000516054 ◽

2021 ◽

pp. 1-6

Author(s):

Yannick Béjot ◽

Gauthier Duloquin ◽

Quentin Thomas ◽

Sophie Mohr ◽

Lucie Garnier ◽

...

Keyword(s):

Young Adults ◽

Sex Differences ◽

Ischemic Stroke ◽

Temporal Trends ◽

Population Based ◽

Incidence Rates ◽

Stroke Incidence ◽

Stroke Registry ◽

Stroke In Young Adults ◽

Stroke In Young

Introduction: Stroke is associated with major consequences in terms of socioeconomic impact and lost disability-adjusted life in young victims, thus justifying a careful surveillance of epidemiological trends. This study aimed to assess changes in the incidence of ischemic stroke in young adults over a long period. Methods: All cases of first-ever ischemic stroke that occurred among adults aged 18–55 years were prospectively recorded using the population-based Dijon Stroke Registry, from 1985 to 2017. Sex-specific annual incidence rates were calculated and were presented according to 6 time periods. Incidence rate ratios (IRRs) were determined to assess sex differences in stroke incidence. Results: Over the whole study period, 4,451 patients suffered a first-ever ischemic stroke. Among these patients, 469 (10.5%) were young adults (median age: 46 years, IQR: 39–50; 53.9% men). Incidence rates rose from the study period 2003 to 2007 compared with previous periods and remained stable thereafter, both in men and women. Hence, incidence per 100,000 per year was globally 11.0 (95% CI: 9.4–12.7) before 2003 and 22.9 (20.3–25.6) thereafter. In individuals aged 18–45 years, incidence rates were 5.4 (4.3–6.9) overall, 4.1 (2.7–6.0) in men, and 6.7 (4.9–9.0) in women, before 2003. After 2003, incidence rates rose to 12.8 (10.7–15.1) overall, 12.0 (9.2–15.4) in men, and 13.6 (10.6–17.0) in women. In this age group, the men/women IRR was 0.78 (95% CI: 0.62–1.26, p = 0.08), although sex differences decreased over time (IRR = 0.62; 95% CI: 0.36–1.02, p = 0.046 before 2003, vs. IRR = 0.88; 95% CI: 0.62–1.26, p = 0.48 after 2003). In individuals aged 45–55 years, incidence rates before 2003 were 47 (37–61) in men and 25 (17–35) in women (IRR = 1.90; 95% CI: 1.24–2.97, p < 0.001), and they increased to 82 (67–100) in men and 46 (35–59) in women (IRR = 1.79; 95% CI: 1.29–2.49, p < 0.001) after 2003. Conclusions: The incidence of ischemic stroke in young adults increased during the early 2000s and remained stable thereafter. These results highlight the priority need for dedicated prevention strategies for the young to reduce the burden of stroke.

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The involvement of the factor V G1691A gene on recurrent ischemic stroke in young adults

Journal of the Neurological Sciences ◽

10.1016/j.jns.2021.118692 ◽

2021 ◽

Vol 429 ◽

pp. 118692

Author(s):

Lamia Mbarek ◽

Salma Sakka ◽

Fatma Megdich ◽

Khadija Sonda Moalla ◽

Nadia Bouattour ◽

...

Keyword(s):

Young Adults ◽

Ischemic Stroke ◽

Factor V ◽

Stroke In Young Adults ◽

Factor V G1691a ◽

Stroke In Young

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Abstract WMP53: Traditional Vascular Risk Factors Account for Different Proportions of Ischemic Stroke Within Different Gender and Race Groups

Stroke ◽

10.1161/str.51.suppl_1.wmp53 ◽

2020 ◽

Vol 51 (Suppl_1) ◽

Author(s):

Elizabeth M Aradine ◽

Yan Hou ◽

Kathleen A Ryan ◽

Prachi Mehndiratta ◽

Michael S Phipps ◽

...

Keyword(s):

Risk Factors ◽

Young Adults ◽

Ischemic Stroke ◽

Black Men ◽

White Men ◽

Vascular Risk Factors ◽

Vascular Risk ◽

Odds Ratios ◽

Stroke In Young Adults ◽

Stroke In Young

Introduction: Few studies have compared the proportion of ischemic strokes attributable to traditional vascular risk factors (population-attributable risk percent or PAR%) between genders and races. The PAR% is a function of the population prevalence and strength of association of a risk factor. Methods: A population-based case-control study of ischemic stroke in young adults ages 18-49 in the Baltimore-Washington region was used to study the prevalence, odds ratios, and PAR% of hypertension, diabetes, and smoking among blacks and whites. Logistic regression was used to calculate age-adjusted odds ratios. All analyses were stratified by gender. Results: There were 1044 cases and 1099 controls. Of the cases, 47% were black, 54% were women. Roughly a quarter to a third of all strokes in women were attributable to smoking. Due to the higher prevalence of hypertension and a higher odds ratio for hypertension in black men (OR 3.9, 95% CI 2.6-5.9) compared to white men (OR 1.8, 95% CI 1.3-2.6), there was a much higher PAR% for hypertension among black men than white men. See Table 1 for prevalence and Table 2 for PAR% stratified by gender and race. Conclusion: Traditional vascular risk factors have the potential to explain a high proportion of ischemic stroke in young adults. The high proportion of strokes in women attributable to smoking underscores the need for targeted smoking cessation interventions in this population. Diabetes and, especially, hypertension are important contributors to the excess population burden of ischemic stroke among blacks. These findings support the value of early screening and treatment for hypertension in young blacks.

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