title: Age-dependent differences in demographics, risk factors, co-morbidity, etiology, management, and clinical outcome of acute ischemic stroke.
abstract: BACKGROUND
  Comparisons between younger and older stroke patients including comorbidities are limited.
  
  
  METHODS
  Prospective data of consecutive patients with first ever acute ischemic stroke were compared between younger (< or = 45 years) and older patients (> 45 years).
  
  
  RESULTS
  Among 1004 patients, 137 (14 %) were < or = 45 years. Younger patients were more commonly female (57 % versus 34 %; p < 0.0001), had a lower frequency of diabetes (1 % versus 15 %; p < 0.0001), hypercholesterolemia (26 % versus 56 %; p < 0.0001), hypertension (19 % versus 65 %; p < 0.0001), coronary heart disease (14 % versus 40 %; p < 0.0001), and a lower mean Charlson co-morbidity index (CCI), (0.18 versus 0.84; p < 0.0001). Tobacco use was more prevalent in the young (39 % versus 26 %; P < 0.0001). Large artery disease (2 % versus 21 %; p < 0.0001), small artery disease (3 % versus 12 %; p = 0.0019) and atrial fibrillation (1 % versus 17 %; p = 0.001) were less common in young patients, while other etiologies (31 % versus 9 %; p < 0.0001), patent foramen ovale or atrial septal defect (44 % versus 26 %; p < 0.0001), and cervical artery dissection (26 % versus 7 %; p < 0.0001) were more frequent. A favorable outcome (mRS 0 or 1) was more common (57.4 % versus 46.9 %; p = 0.023), and mortality (5.1 % versus 12 %; p = 0.009) was lower in the young. After regression analysis, there was no independent association between age and outcome (p = 0.206) or mortality (p = 0.073). Baseline NIHSS score (p < 0.0001), diabetes (p = 0.041), and CCI (p = 0.002) independently predicted an unfavorable outcome.
  
  
  CONCLUSIONS
  Younger patients were more likely to be female, had different risk factors and etiologies and fewer co-morbidities. There was no independent association between age and clinical outcome or mortality.
authors.affiliation: Department of Neurology, University Hospital, Inselspital, Freiburgstrasse, 3010 Berne, Switzerland. marcel.arnold@insel.ch
authors.forename: M
authors.initials: M
authors.lastname: Arnold
authors.forename: M
authors.initials: M
authors.lastname: Halpern
authors.forename: N
authors.initials: N
authors.lastname: Meier
authors.forename: U
authors.initials: U
authors.lastname: Fischer
authors.forename: T
authors.initials: T
authors.lastname: Haefeli
authors.forename: L
authors.initials: L
authors.lastname: Kappeler
authors.forename: C
authors.initials: C
authors.lastname: Brekenfeld
authors.forename: H P
authors.initials: HP
authors.lastname: Mattle
authors.forename: K
authors.initials: K
authors.lastname: Nedeltchev
mesh_terms: D000208:Acute Disease / Q000453:epidemiology; D000328:Adult; D000367:Age Factors; D015897:Comorbidity; D003710:Demography; D005260:Female; D006801:Humans; D007511:Ischemia / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D012044:Regression Analysis; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy; D016896:Treatment Outcome