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Title: Age as a determinant of risk factors and causes in ischaemic stroke.
Author: Sahathevan, Ramesh
Siriratnam, Pakeeran
O'Connor, Ellie
Godfrey, Amelia
Hu, Chih-Chiang
Low, Ashlea
Hair, Casey
Kraemer, Thomas
Lau, Mandy
Sharma, Anand
Oqueli, Ernesto
Issue Date: 2018
Conference Name: Ballarat Health Services 2018 Annual Research Symposium: research partnerships for population, people and patients; celebrating our research partnerships with the community in the Grampians region
Conference Date: November 29th
Conference Place: Ballarat
Abstract: Background Ischaemic strokes are increasingly occurring at a younger age. Recent studies suggest that the risk factor profile in the younger population is similar to that of older patients. If true, this may warrant a shift in the diagnostic and management approach to young strokes. Objectives/Aims A) Assess the risk factors and mechanism of stroke in patients under 50 compared to those 51-60 and over 60 years of age. B) Determine an appropriate age cut-off for defining young strokes based on the risk factor profile and causes of the stroke. Method We conducted a retrospective analysis from 2015-2017 of 391 ischaemic stroke patients. We collected data on common risk factors and mechanism of strokes, based on TOAST criteria. Results There were 30 (7.7%) patients between the ages of 20-50, 40 (10.2%) between 51-60 and 321 (82.1%) over 61. Under the age of 50, the commonest risk factors were smoking (60%) and hypertension (36.7%). Similarly, in the 51-60 age group, smoking was most prevalent (72.5%) followed by hypertension (50%). In those over 61, hypertension was the most frequent risk factor (84.5%) followed by smoking (42.6%). The mechanism of stroke in those less than 50 under were undetermined aetiology (46.7%), cardioembolism (23.3%), small vessel disease (13.3%), other causes (10%) and large artery atherosclerosis (6.7%). In the 51-60 group, the order was cryptogenic and cardioembolism (27.5% each), large artery atherosclerosis (22.5%), small vessel disease (20%) and other causes (2.5%). In the over 61 group, the causes were cardioembolism (43.3%), large artery atherosclerosis (18.7%), small vessel disease (18.1%), undetermined etiology (18.1%) and other causes (1.9%). Implications/Outcomes for Planned Research Project A) Risk factors for stroke are similar in the 50-60 group compared to those over 60. This suggests that the WHO definition of young stroke be reviewed and the under 50 cut-off applied universally. B) In patients under 50, the high prevalence of traditional vascular risk factors suggests that extensive investigations may be unnecessary and should be reserved for selected patients. Final Thoughts Our audit reflects the growing number of younger people developing stroke secondary to modifiable risk factors. Our sample size is too small for definitive recommendations and therefore, a similar assessment in a larger population is warranted.
Internal ID Number: 01266
Type: Conference
Appears in Collections:Research Output

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