Abstract Details

Title Long-Term Mortality after Stroke in Young Adults: The FUTURE Study

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) S09 - (-)

Poster/Presentation
Number 004

Objective

Background Long-term data on mortality after first-ever stroke in young adults are scarce and usually restricted to ischemic stroke (IS). Moreover, expected mortality not related to young stroke is not taken in account.

Design/Methods FUTURE study, a prospective cohort study on prognosis after ischemic or hemorrhagic stroke in young adults, aged 18-50 years admitted to our hospital between 1-1-1980 till 1-11-2010. We assessed the survival status in 959 consecutive patients with a first-ever TIA (n=262), IS (n=606) or intracerebral hemorrhage (ICH) (n=91). Mean follow-up duration was 10.8 years. Observed mortality was compared with the expected mortality, derived from mortality rates in the general population with similar age, sex and calendar-year characteristics.

Results 187 (19.5%) Patients had died at the end of follow up. Among 30-day survivors cumulative 30-year risk of death was 28.2% (95% CI, 18.4-38.1), 38.4% (95% CI, 30.5-46.3) and 43.8% (95% CI, 7.8-79.8) for TIA, IS and ICH respectively. Observed mortality among TIA, IS and ICH was increased compared to expected mortality (standardized mortality ratio (SMR) 2.6 (95% CI, 1.8-3.7), 3.9 (95% CI, 3.2-4.7) and 3.6 (95% CI, 1.7-6.9) respectively). Age of onset, cardioembolic stroke and coexisting cause of stroke were independently associated with long-term mortality after IS in multivariable analyses (HR, 1.06 [95%CI, 1.03-1.09]; HR, 3.92 [95%CI, 2.13-7.23]; HR 3.40 [95%CI, 1.25-9.28], respectively). For all TOAST subtypes of IS, observed mortality exceeded expected mortality.

Conclusions A young stroke strikes acute, but has life-long consequences. Clinical practice may need to extend the acute secondary prevention programs towards a life-long surveillance and treatment of risk factors and life style.

Authors/Disclosures
Frank-Erik De Leeuw, MD, PhD (UMC St. Radboud) PRESENTER	No disclosure on file
	No disclosure on file
David E. Thaler, MD, PhD, FAAN (Tufts Medical Center)	Dr. Thaler has nothing to disclose.
	No disclosure on file
	No disclosure on file
	No disclosure on file
Lucille Dorresteijn, MD (University Medical Center Nijmegen)	No disclosure on file
Ewoud J. Van Dijk, MD, PhD	No disclosure on file

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