Risk factors, aetiology and outcome of ischaemic stroke in young adults: the Swiss Young Stroke Study (SYSS).

Détails

ID Serval
serval:BIB_0EAD25FD1E15
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Risk factors, aetiology and outcome of ischaemic stroke in young adults: the Swiss Young Stroke Study (SYSS).
Périodique
Journal of Neurology
Auteur(s)
Goeggel Simonetti B., Mono M.L., Huynh-Do U., Michel P., Odier C., Sztajzel R., Lyrer P., Engelter S.T., Bonati L., Gensicke H., Traenka C., Tettenborn B., Weder B., Fischer U., Galimanis A., Jung S., Luedi R., De Marchis G.M., Weck A., Cereda C.W., Baumgartner R., Bassetti C.L., Mattle H.P., Nedeltchev K., Arnold M.
ISSN
1432-1459 (Electronic)
ISSN-L
0340-5354
Statut éditorial
Publié
Date de publication
2015
Peer-reviewed
Oui
Volume
262
Numéro
9
Pages
2025-2032
Langue
anglais
Notes
Publication types: Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Résumé
Ischaemic stroke (IS) in young adults has been increasingly recognized as a serious health condition. Stroke aetiology is different in young adults than in the older population. This study aimed to investigate aetiology and risk factors, and to search for predictors of outcome and recurrence in young IS patients. We conducted a prospective multicentre study of consecutive IS patients aged 16-55 years. Baseline demographic data, risk factors, stroke aetiology including systematic genetic screening for Fabry disease and severity were assessed and related to functional neurological outcome (modified Rankin Scale, mRS), case fatality, employment status, place of residence, and recurrent cerebrovascular events at 3 months. In 624 IS patients (60% men), median age was 46 (IQR 39-51) years and median NIHSS on admission 3 (IQR 1-8). Modifiable vascular risk factors were found in 73%. Stroke aetiology was mostly cardioembolism (32%) and of other defined origin (24%), including cervicocerebral artery dissection (17%). Fabry disease was diagnosed in 2 patients (0.3%). Aetiology remained unknown in 20%. Outcome at 3 months was favourable (mRS 0-1) in 61% and fatal in 2.9%. Stroke severity (p < 0.001) and diabetes mellitus (p = 0.023) predicted unfavourable outcome. Stroke recurrence rate at 3 months was 2.7%. Previous stroke or TIA predicted recurrent cerebrovascular events (p = 0.012). In conclusion, most young adults with IS had modifiable vascular risk factors, emphasizing the importance of prevention strategies. Outcome was unfavourable in more than a third of patients and was associated with initial stroke severity and diabetes mellitus. Previous cerebrovascular events predicted recurrent ones.
Mots-clé
Adolescent, Adult, Brain Ischemia/etiology, Brain Ischemia/therapy, Female, Humans, Male, Middle Aged, Prognosis, Prospective Studies, Recurrence, Risk Factors, Severity of Illness Index, Stroke/etiology, Stroke/therapy, Switzerland, Treatment Outcome, Young Adult
Pubmed
Web of science
Création de la notice
17/11/2015 17:38
Dernière modification de la notice
20/08/2019 12:35
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