Objective:

The aim for our study was to identify the most common risk factors and rates of acute stroke interventions in young patients with stroke evaluated at our regional center.

Background:

Design/Methods:

This was a single-center retrospective study of stroke patients aged < 55 (n=1514), who presented to our hospital between 2015-2022.

Results:

Ischemic stroke was seen in 1024 (67.6%), TIA in 72 (4.8%) and ICH in 418 (27.5%). Mean age for ischemic stroke was 47 and for ICH was 45. The most common risk factor was Obesity (BMI≥30), present in 76.4% of patients. Hypertension was the second most common, present in 67.1%. Smoking was seen in 50.6%, Hyperlipidemia in 39.1%, and Diabetes in 24.6% of the patients. Drug and alcohol abuse was present in 30.4% of the cohort. The most common etiologies were Cardioembolic (28.5%) and cryptogenic (25.9%), followed by Small Vessel (18%) and Large Artery Atherosclerosis (15.4%). Only 200/1024 (19.5%) of all ischemic strokes arrived within 4.5hr tPA window and 103 (51.5%) received thrombolytics. 28% of all ischemic strokes underwent mechanical thrombectomy. Lastly, there was a significant improvement in modified Rankin scales from admission to discharge in patients with ischemic stroke (2.797±0.056 to 2.317±0.058; p<0.0001).

Conclusions:

Obesity was the most common vascular risk factor associated with ischemic stroke in the young population in our region. Hypertension was the second most common, showing the need to implement health promotion strategies and improve primary stroke prevention in young adults. Fewer patients also received acute interventions due to late presentation, raising concerns on lack of early recognition of stroke symptoms in this age group. The overall stroke outcome, however, was favorable in this population.