Ekker MS, et al. - Researchers performed this Dutch register-based cohort study to determine the age- and sex-specific case fatality and long-term mortality associated with stroke among young adults. This study included 15,527 patients who had the first stroke between the ages 18 of 49 years in 1998-2010; they were followed up until January 1, 2017. Observations revealed that young adults who were 30-day survivors, continuously have elevated mortality risk up to 15 years after stroke.

Methods

• The investigators identified patients and outcomes via linking the national Hospital Discharge Registry, national Cause of Death Registry, and the Dutch Population Register.
• Exposures included first stroke occurring between the ages of 18 to 49 years, which were 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.
• As the primary outcome, 30-day survivors at end of follow-up were assessed for all-cause cumulative mortality stratified by age, sex, and stroke subtype.
• Comparison to all-cause cumulative mortality in the general population was also done.

Results

• At end of follow-up, over 3,500 cumulative deaths were reported, including 1,776 deaths within 30 days post-stroke and 1,764 deaths during a median duration of follow-up of 9.3 years
• The 15-year mortality in 30-day survivors was 17.0% (95% CI: 16.2% to 17.9%).
• Compared with the general population, the standardized mortality rate was 5.1 for ischemic stroke, and the standardized mortality rate for intracerebral hemorrhage was 8.4.