Association of Stroke Among Adults Aged 18 to 49 Years With Long-term Mortality

作者：Merel S. Ekker, Jamie I. Verhoeven, Ilonca Vaartjes, Wilhelmus Martinus Tim Jolink, Catharina Johanna Maria Klijn, Frank‐Erik de Leeuw · 发表于：JAMA · 年份：2019 · DOI：10.1001/jama.2019.6560 · 被引用次数：101 · 研究领域：Acute Ischemic Stroke Management、Blood Coagulation and Thrombosis Mechanisms、Stroke Rehabilitation and Recovery

Importance: Stroke remains the second leading cause of death worldwide. Approximately 10% to 15% of all strokes occur in young adults. Information on prognosis and mortality specifically in young adults is limited. Objective: To determine short- and long-term mortality risk after stroke in young adults, according to age, sex, and stroke subtype; time trends in mortality; and causes of death. Design, Setting, and Participants: Registry- and population-based study in the Netherlands of 15 527 patients aged 18 to 49 years with first stroke between 1998 and 2010, and follow-up until January 1, 2017. Patients and outcomes were identified through linkage of the national Hospital Discharge Registry, national Cause of Death Registry, and the Dutch Population Register. Exposures: First stroke occurring at age 18 to 49 years, documented using International Classification of Diseases, Ninth Revision, and International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, codes for ischemic stroke, intracerebral hemorrhage, and stroke not otherwise specified. Main Outcomes and Measures: Primary outcome was all-cause cumulative mortality in 30-day survivors at end of follow-up, stratified by age, sex, and stroke subtype, and compared with all-cause cumulative mortality in the general population. Results: The study population included 15 527 patients with stroke (median age, 44 years [interquartile range, 38-47 years]; 53.3% women). At end of follow-up, a tota...