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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...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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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. |
format | Online Article Text |
id | pubmed-8911514 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
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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