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Comparison of Long-Term Outcomes and Associated Factors between Younger and Older Rural Ischemic Stroke Patients

Introduction: The rise of ischemic stroke among young adults has stressed the need to understand their risk profiles and outcomes better. This study aimed to examine the five-year ischemic stroke recurrence and survival probability among young patients in rural Pennsylvania. Methods: This retrospect...

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Autores principales: Chaudhary, Durgesh, Anyaehie, Michelle, Demiraj, Francis, Bavishi, Shreya, Shahjouei, Shima, Li, Jiang, Abedi, Vida, Zand, Ramin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8911514/
https://www.ncbi.nlm.nih.gov/pubmed/35268521
http://dx.doi.org/10.3390/jcm11051430
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author Chaudhary, Durgesh
Anyaehie, Michelle
Demiraj, Francis
Bavishi, Shreya
Shahjouei, Shima
Li, Jiang
Abedi, Vida
Zand, Ramin
author_facet Chaudhary, Durgesh
Anyaehie, Michelle
Demiraj, Francis
Bavishi, Shreya
Shahjouei, Shima
Li, Jiang
Abedi, Vida
Zand, Ramin
author_sort Chaudhary, Durgesh
collection PubMed
description Introduction: The rise of ischemic stroke among young adults has stressed the need to understand their risk profiles and outcomes better. This study aimed to examine the five-year ischemic stroke recurrence and survival probability among young patients in rural Pennsylvania. Methods: This retrospective cohort study included first-time ischemic stroke patients from the Geisinger Health System between September 2003 and May 2014. The outcomes included all-cause mortality and ischemic stroke recurrence at five years. Kaplan-Meier estimator, cumulative incidence function, Cox proportional hazards model, and Cause-specific hazard model were used to examine the association of independent variables with the outcomes. Results: A total of 4459 first-time ischemic stroke patients were included in the study, with 664 (14.9%) patients in the 18–55 age group and 3795 (85.1%) patients in the >55 age group. In the 18–55 age group, the five-year survival probability was 87.2%, and the cumulative incidence of recurrence was 8%. Patients in the 18–55 age group had significantly lower hazard for all-cause mortality (HR = 0.37, 95% CI 0.29–0.46, p < 0.001), and non-significant hazard for five-year recurrence (HR = 0.81, 95% CI 0.58–1.12, p = 0.193) compared to the >55 age group. Chronic kidney disease was found to be associated with increased mortality in the 18–55 age group. Conclusion: In our rural population, younger ischemic stroke patients were at the same risk of long-term ischemic stroke recurrence as the older ischemic stroke patients. Identifying the factors and optimizing adequate long-term secondary prevention may reduce the risk of poor outcomes among younger ischemic stroke patients.
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spelling pubmed-89115142022-03-11 Comparison of Long-Term Outcomes and Associated Factors between Younger and Older Rural Ischemic Stroke Patients Chaudhary, Durgesh Anyaehie, Michelle Demiraj, Francis Bavishi, Shreya Shahjouei, Shima Li, Jiang Abedi, Vida Zand, Ramin J Clin Med Article Introduction: The rise of ischemic stroke among young adults has stressed the need to understand their risk profiles and outcomes better. This study aimed to examine the five-year ischemic stroke recurrence and survival probability among young patients in rural Pennsylvania. Methods: This retrospective cohort study included first-time ischemic stroke patients from the Geisinger Health System between September 2003 and May 2014. The outcomes included all-cause mortality and ischemic stroke recurrence at five years. Kaplan-Meier estimator, cumulative incidence function, Cox proportional hazards model, and Cause-specific hazard model were used to examine the association of independent variables with the outcomes. Results: A total of 4459 first-time ischemic stroke patients were included in the study, with 664 (14.9%) patients in the 18–55 age group and 3795 (85.1%) patients in the >55 age group. In the 18–55 age group, the five-year survival probability was 87.2%, and the cumulative incidence of recurrence was 8%. Patients in the 18–55 age group had significantly lower hazard for all-cause mortality (HR = 0.37, 95% CI 0.29–0.46, p < 0.001), and non-significant hazard for five-year recurrence (HR = 0.81, 95% CI 0.58–1.12, p = 0.193) compared to the >55 age group. Chronic kidney disease was found to be associated with increased mortality in the 18–55 age group. Conclusion: In our rural population, younger ischemic stroke patients were at the same risk of long-term ischemic stroke recurrence as the older ischemic stroke patients. Identifying the factors and optimizing adequate long-term secondary prevention may reduce the risk of poor outcomes among younger ischemic stroke patients. MDPI 2022-03-05 /pmc/articles/PMC8911514/ /pubmed/35268521 http://dx.doi.org/10.3390/jcm11051430 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Chaudhary, Durgesh
Anyaehie, Michelle
Demiraj, Francis
Bavishi, Shreya
Shahjouei, Shima
Li, Jiang
Abedi, Vida
Zand, Ramin
Comparison of Long-Term Outcomes and Associated Factors between Younger and Older Rural Ischemic Stroke Patients
title Comparison of Long-Term Outcomes and Associated Factors between Younger and Older Rural Ischemic Stroke Patients
title_full Comparison of Long-Term Outcomes and Associated Factors between Younger and Older Rural Ischemic Stroke Patients
title_fullStr Comparison of Long-Term Outcomes and Associated Factors between Younger and Older Rural Ischemic Stroke Patients
title_full_unstemmed Comparison of Long-Term Outcomes and Associated Factors between Younger and Older Rural Ischemic Stroke Patients
title_short Comparison of Long-Term Outcomes and Associated Factors between Younger and Older Rural Ischemic Stroke Patients
title_sort comparison of long-term outcomes and associated factors between younger and older rural ischemic stroke patients
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8911514/
https://www.ncbi.nlm.nih.gov/pubmed/35268521
http://dx.doi.org/10.3390/jcm11051430
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