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Prospective observational study of young adult ischemic stroke patients

OBJECTIVE: Ischemic stroke (IS) in young patients may differ in etiology and prognosis from later‐life IS, which is much more common. A number of single‐center and population‐based cohorts of affected individuals have been published, but information on the long‐term prognosis of these patients is li...

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Autores principales: Shihmanter, Renata, Friedman, Joshua, Kushner, Natali, Miller, Edward B., Schattner, Ami
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8442588/
https://www.ncbi.nlm.nih.gov/pubmed/34423914
http://dx.doi.org/10.1002/brb3.2283
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author Shihmanter, Renata
Friedman, Joshua
Kushner, Natali
Miller, Edward B.
Schattner, Ami
author_facet Shihmanter, Renata
Friedman, Joshua
Kushner, Natali
Miller, Edward B.
Schattner, Ami
author_sort Shihmanter, Renata
collection PubMed
description OBJECTIVE: Ischemic stroke (IS) in young patients may differ in etiology and prognosis from later‐life IS, which is much more common. A number of single‐center and population‐based cohorts of affected individuals have been published, but information on the long‐term prognosis of these patients is limited. METHODS: IS patients (≤55 years), discharged over a 10‐year period, were evaluated and prospectively followed. Subgroups were evaluated for type of stroke, antecedent risk factors (RF), long‐term outcomes, and occupational status over several years of follow‐up. RESULTS: 178 IS individuals from 2001–2010 were divided into older (46–55, n = 118) and younger (18–45, n = 60) age groups. Traditional RF—hypertension, diabetes mellitus, hyperlipidemia—were significantly associated with IS, and increased with age. The distribution and type of IS were similar in both groups, except for an increase in small vessel IS among the older subgroup (p = .003). Of the evaluable patients at 5.1 ± 2.5 years of follow‐up (n = 138), a similar proportion of patients in both subgroups had a recurrent IS, but no significant differences were found in most disability indices. Approximately one third of patients suffered from moderate to severe disability, and were unable to return to their prior work. CONCLUSIONS: Younger and older IS patients are generally predisposed from the same traditional RF which progress with age. Long‐term disabilities tend to worsen over time due to recurrent vascular events. These data emphasize the need for a strategy for early identification of the already well‐known stroke RF in younger stroke patients.
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spelling pubmed-84425882021-09-15 Prospective observational study of young adult ischemic stroke patients Shihmanter, Renata Friedman, Joshua Kushner, Natali Miller, Edward B. Schattner, Ami Brain Behav Original Research OBJECTIVE: Ischemic stroke (IS) in young patients may differ in etiology and prognosis from later‐life IS, which is much more common. A number of single‐center and population‐based cohorts of affected individuals have been published, but information on the long‐term prognosis of these patients is limited. METHODS: IS patients (≤55 years), discharged over a 10‐year period, were evaluated and prospectively followed. Subgroups were evaluated for type of stroke, antecedent risk factors (RF), long‐term outcomes, and occupational status over several years of follow‐up. RESULTS: 178 IS individuals from 2001–2010 were divided into older (46–55, n = 118) and younger (18–45, n = 60) age groups. Traditional RF—hypertension, diabetes mellitus, hyperlipidemia—were significantly associated with IS, and increased with age. The distribution and type of IS were similar in both groups, except for an increase in small vessel IS among the older subgroup (p = .003). Of the evaluable patients at 5.1 ± 2.5 years of follow‐up (n = 138), a similar proportion of patients in both subgroups had a recurrent IS, but no significant differences were found in most disability indices. Approximately one third of patients suffered from moderate to severe disability, and were unable to return to their prior work. CONCLUSIONS: Younger and older IS patients are generally predisposed from the same traditional RF which progress with age. Long‐term disabilities tend to worsen over time due to recurrent vascular events. These data emphasize the need for a strategy for early identification of the already well‐known stroke RF in younger stroke patients. John Wiley and Sons Inc. 2021-08-22 /pmc/articles/PMC8442588/ /pubmed/34423914 http://dx.doi.org/10.1002/brb3.2283 Text en © 2021 The Authors. Brain and Behavior published by Wiley Periodicals LLC https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Research
Shihmanter, Renata
Friedman, Joshua
Kushner, Natali
Miller, Edward B.
Schattner, Ami
Prospective observational study of young adult ischemic stroke patients
title Prospective observational study of young adult ischemic stroke patients
title_full Prospective observational study of young adult ischemic stroke patients
title_fullStr Prospective observational study of young adult ischemic stroke patients
title_full_unstemmed Prospective observational study of young adult ischemic stroke patients
title_short Prospective observational study of young adult ischemic stroke patients
title_sort prospective observational study of young adult ischemic stroke patients
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8442588/
https://www.ncbi.nlm.nih.gov/pubmed/34423914
http://dx.doi.org/10.1002/brb3.2283
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