Stroke is among the most devastating consequences of SCD. Up to 24% can develop stroke by age 45, but there has not been major advancements in adult strokes with SCD. 

Patients with SCD were identified from the state-wide Florida Stroke Registry (FSR) comprising of 153 hospitals that use the AHA GWTG-Stroke quality improvement metric data collected during stroke hospitalization. Here we present demographics, clinical characteristics, and outcomes at discharge of SCD from the FSR.

Between January 2010 and May 2021, 396,741 strokes were included in the FSR, of which 338 had SCD (59% women, age 48±18 years (range 4-93), 81% black, 12% white, 7% Hispanic, 75% ischemic stroke, 7% TIA, 12% ICH, 6% SAH). More SCD strokes occurred between ages 32-41 (19%) than any other decade, and 75% under 61 years. Compared to those without SCD, SCD patients were significantly younger (48 vs. 70), more likely to ambulate independently at discharge (54.7% vs. 40.3%), less likely to get discharged to a nursing facility (10% vs. 17%) and more likely to be discharged home (60% vs. 50%), with a trend towards better functional status at discharge (modified Rankin Score 0-2 [53% vs. 46%] and 3-5 [47% vs. 54%], p=0.07), despite similar NIHSS on presentation (median 4, p=0.9), or in-hospital mortality (6.3% vs. 5.3%%, p=0.4).

Adult SCD stroke patients present at a younger age, and during their most productive working age. Although patients with SCD have more favorable discharge outcomes than those without SCD, almost half of adult patients do not ambulate independently at discharge. Further research is needed on long term outcomes and the quality of systems of care for SCD patients that transition from childhood to adults.