title: Severity and outcomes according to stroke etiology in patients under 50 years of age with ischemic stroke.
abstract: To analyze the association of stroke etiological subtypes with severity and outcomes at 3 and 12 months in patients ≤50 years. Observational study of patients admitted to a stroke unit (2007-2013).
  
  
  METHODS
  demographic data, vascular risk factors, comorbidities, severity on admission (NIHSS), and good functional outcome (mRS ≤ 1) at 3 and 12 months. We used multivariate analyses to evaluate the influence of stroke etiology on severity and outcomes. We included 214 patients, 58.3 % men, mean age 41.4 years. General linear models showed all etiologies were more severe than lacunar strokes (P < 0.05). Atherothrombotic strokes showed greater severity than those of undetermined and uncommon etiology, whereas cardioembolic strokes were more severe than cryptogenic. Taking into account specific etiologies, atherothrombotic strokes (B = 5.860; 95 % CI 2.979-8.751), cervical artery dissection (CAD) [B = 7.485; 95 % confidence interval (CI) 4.734-10.237], and atrial fibrillation (AF) strokes (B = 5.773; 95 % CI 2.704-8.132) were more severe than other etiologies. Logistic regression models showed that strokes of uncommon etiology, especially those not related to CAD, had a lower probability of good outcome at 3 months [odds ratio (OR) = 0.197; CI 95 % 0.044-0.873], whereas atherothrombotic strokes were associated with this probability at 12 months (OR = 0.187; 95 % CI 0.037-0.951; P = 0.007). In patients ≤50 years of age, strokes of atherothrombotic, cardioembolic (particularly those due to AF), and uncommon etiology had a greater severity than the rest. Furthermore, strokes of uncommon etiology, especially those different from CAD, decreased the probability of a good outcome at 3 months, as did atherothrombotic strokes at 1 year.
authors: Department of Neurology and Stroke Center, La Paz University Hospital, IdiPAZ Health Research Institute, Autonomous University of Madrid, Paseo de la Castellana 261, 28046, Madrid, Spain.
authors: Daniel
authors: D
authors: Prefasi
authors: Department of Neurology and Stroke Center, La Paz University Hospital, IdiPAZ Health Research Institute, Autonomous University of Madrid, Paseo de la Castellana 261, 28046, Madrid, Spain. patrindalo@hotmail.com.
authors: Patricia
authors: P
authors: Martínez-Sánchez
authors: Department of Neurology and Stroke Center, La Paz University Hospital, IdiPAZ Health Research Institute, Autonomous University of Madrid, Paseo de la Castellana 261, 28046, Madrid, Spain.
authors: Blanca
authors: B
authors: Fuentes
authors: Department of Neurology and Stroke Center, La Paz University Hospital, IdiPAZ Health Research Institute, Autonomous University of Madrid, Paseo de la Castellana 261, 28046, Madrid, Spain. exuperio.diez@salud.madrid.org.
authors: Exuperio
authors: E
authors: Díez-Tejedor
mesh_terms: D000328:Adult; D000367:Age Factors; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D012720:Severity of Illness Index; D020521:Stroke / Q000175:diagnosis* / Q000209:etiology*; D013997:Time Factors
keywords: Stroke; Stroke etiology; Stroke in young adults; Stroke outcomes; Stroke severity