title: Deaths from stroke in US young adults, 1989-2009.
abstract: OBJECTIVE
  To determine what the trends in stroke mortality have been over 2 decades in young adults.
  
  
  METHODS
  In this cohort study, we analyzed death certificate data for ischemic and hemorrhagic stroke (intracerebral hemorrhage [ICH] and subarachnoid hemorrhage [SAH]) in adults aged 20-44 in the United States for 1989 through 2009, covering approximately 2.2 billion person-years. Poisson regression was used to calculate and compare time trend data between groups and to compare trends in young adults to those in adults over age 45.
  
  
  RESULTS
  Mortality from stroke in young adults declined by 35% over the study period, with reductions in all 3 stroke subtypes (ischemic stroke decreased by 15%, ICH by 47%, and SAH by 50%). Black race was a risk factor for all 3 stroke subtypes (relative risk 2.4 for ischemic stroke, 4.0 for ICH, and 2.1 for SAH), but declines in all stroke subtypes were more dramatic in black compared to white participants (p < 0.001 for all stroke subtypes).
  
  
  CONCLUSIONS
  Although hospitalizations for stroke in young patients have been increasing, the apparent decrease in mortality rates and in racial disparities suggests that recognition and treatment in this group may be improving.
authors.affiliation: From the Department of Neurology (S.N.P.), University of Colorado Denver, Aurora; the Departments of Epidemiology and Biostatistics (D.G.) and Neurology and Pediatrics (H.J.F.), University of California San Francisco; and Dell Medical School (S.C.J.), University of Texas, Austin. Sharon.Poisson@ucdenver.org.
authors.forename: Sharon N
authors.initials: SN
authors.lastname: Poisson
authors.affiliation: From the Department of Neurology (S.N.P.), University of Colorado Denver, Aurora; the Departments of Epidemiology and Biostatistics (D.G.) and Neurology and Pediatrics (H.J.F.), University of California San Francisco; and Dell Medical School (S.C.J.), University of Texas, Austin.
authors.forename: David
authors.initials: D
authors.lastname: Glidden
authors.affiliation: From the Department of Neurology (S.N.P.), University of Colorado Denver, Aurora; the Departments of Epidemiology and Biostatistics (D.G.) and Neurology and Pediatrics (H.J.F.), University of California San Francisco; and Dell Medical School (S.C.J.), University of Texas, Austin.
authors.forename: S Claiborne
authors.initials: SC
authors.lastname: Johnston
authors.affiliation: From the Department of Neurology (S.N.P.), University of Colorado Denver, Aurora; the Departments of Epidemiology and Biostatistics (D.G.) and Neurology and Pediatrics (H.J.F.), University of California San Francisco; and Dell Medical School (S.C.J.), University of Texas, Austin.
authors.forename: Heather J
authors.initials: HJ
authors.lastname: Fullerton
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American; D002545:Brain Ischemia / Q000401:mortality*; D002543:Cerebral Hemorrhage / Q000401:mortality*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D020300:Intracranial Hemorrhages / Q000401:mortality*; D008297:Male; D012307:Risk Factors; D020521:Stroke / Q000401:mortality*; D014481:United States; D044465:White People