A new study published by JAMA Neurology examines hospitalization rates for acute ischemic stroke in “younger” adults (18 to 64 years of age) by stroke type and patient age, sex, and race/ethnicity, along with associated risk factors.
The study by Mary G. George, MD, MSPH, and her colleagues at the Centers for Disease Control and Prevention used hospitalization data from the National Inpatient Sample, a database of inpatient stays derived from billing data.
The study found that hospitalizations for acute ischemic stroke among those aged 18 to 64 years increased from an average of 141,474 per year in 2003–2004 to 171,386 per year in 2011–2012––representing a 20% to 40% jump in hospitalization rates. Moreover, the investigators found across-the-board increases in vascular risk factor diagnoses in young adults discharged with an ischemic stroke.
“The identification of increasing hospitalization rates for acute ischemic stroke in young adults coexistent with [an] increasing prevalence of traditional stroke risk factors confirms the importance of focusing on prevention in younger adults,” the authors write.
An accompanying editorial by James F. Burke, MD, MS, and Lesli E. Skolarus, MD, MS, of the University of Michigan, Ann Arbor, takes a closer look at the study.
“If a headline such as ‘Stroke Tsunami: 30,000 More Strokes in the Young’ pops into your Twitter feed based on a study in this month’s issue of JAMA Neurology, should the claim be taken seriously?” Burke and Skolarus ask. “Maybe, but the evidence is pretty cloudy.”
They go on to suggest that the study results might have captured changes in the measurement system or may have been influenced by other factors. For example, population growth would be expected to account for approximately half of the stroke increase reported in the study, the editorial points out.
“It is startling that in a country that spends almost 20% of the largest gross domestic product on the planet on health care, we cannot say with confidence whether the fifth leading cause of death in the United States is increasing or decreasing in the young. Yet, that is precisely our state of affairs,” Burke and Skolarus write.