Risk factors and mechanisms of ischaemic stroke in regional Australia- an age-based analysis.

Abstract

Background and Aims: Stroke is the second leading cause of mortality globally. Commonly seen as a disease of the aging, ischaemic strokes are increasingly occurring at younger ages. Recent studies suggest that the profile of young stroke patients is similar to that of the older population, particularly in relation to risk factors. We aimed to determine the differences in risk factors and stroke type in our ischaemic stroke population based on age. Methods: We conducted a retrospective analysis of all ischaemic stroke patients admitted to Ballarat Base Hospital from 2015–2017. Data were collected on demographics, risk factor profiles and mechanism of stroke recorded in the hospital stroke database. We dichotomised the population based on an age cut-off of 50 years, and compared the two groups using Pearson’s chi square test or Fishers exact test. Results: We identified 391 ischaemic stroke patients; 30 patients aged 18 to 50, and 361 patients >50 years of age. At least one of the six risk factors assessed was present in 86.7% of the younger group, compared to 97.2% in the older group (P ¼ 0.016). Younger patients were significantly less likely to have modifiable risk factors such as hypertension and ischaemic heart disease compared to the older group, but more likely to have cryptogenic, cardioembolic or other/rare mechanisms of stroke. Conclusions: Although older patients are more likely affected by traditional vascular risk factors, prevalence in those 50 reinforces the importance of primary prevention. The mechanisms of stroke in the 50 group suggests the need for detailed diagnostic work-up