redOrbit Staff & Wire Reports – Your Universe Online
Adults who suffer a stroke before the age of 50 are far more likely to die within the next two decades than the general population, according to a new study published in Wednesday´s edition of JAMA.
According to background information presented with the study, six million people die as a result of stroke, which is a loss of brain function due to a disturbance in the brain´s blood supply. While it primarily affects the elderly, an estimated 10 percent of all strokes occur in patients 18 to 50 years of age. Even so, the researchers report that there has been limited research on the long-term prognosis for stroke survival in this younger group.
Loes C. A. Rutten-Jacobs of Radboud University Nijmegen Medical Centre (UMCN) and colleagues set out to correct that by conducting a long-term mortality and cause-of-death study focusing on first-time stroke victims under 50 years of age. They would then compare their findings with national age and gender-related morality rates.
They focused on 959 patients who were admitted to medical facilities with one of three different types of strokes — transient ischemic attack (TIA), ischemic stroke, or hemorrhagic stroke — between January 1980 and November 2010.
Of those, 262 people suffered a TIA (also known as a mini-stroke), which occurs due to a disruption of blood flow to the brain without tissue death; 606 suffered an ischemic stroke, which occurs when the part of the brain´s blood supply decreases, resulting in damage to the tissue in that area; and 91 suffered an intracerebral hemorrhage, a stroke that originates within the brain itself, often due to trauma.
The survival status of each of those subjects was reviewed as of November 1, 2012, with an average follow-up duration of just over 11 years, Rutten-Jacobs and co-authors explained. During follow-up, 20 percent of the patients (192) had died. Mortality risk was 24.9 percent for TIA patients, 26.8 percent for ischemic stroke patients, and 13.7 percent for intracerebral hemorrhage patients.
They also found that mortality rates were higher for those who survived the first 30 days after an ischemic stroke, and that the cumulative 20-year mortality rate for those stroke victims was higher in men (33.7 percent) than women (19.8 percent). Furthermore, the study revealed an excess in mortality for stroke victims in comparison to the general population, even decades after suffering a cerebrovascular event.
“This may suggest that the underlying (vascular) disease that caused the stroke at relatively young age continues to put these patients at an increased risk for vascular disease throughout their lives,” the authors explained in a statement Tuesday. “It may also be noted that risk factors indicated in the study group, such as smoking and alcohol consumption, seem likely to confer risk as well.”
“Although data are currently lacking, the observation of long-term increased risk for vascular disease could have important implications for the implementation of secondary prevention (both medical and lifestyle) treatment strategies,” they added. “Future studies should address the role of this stringent implementation in these patients with young stroke.”
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