Deans' stroke musings: Association of stroke among adults aged 18 to 49 years with long-term mortality

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Wednesday, May 29, 2019

Association of stroke among adults aged 18 to 49 years with long-term mortality

I just miss qualifying as a young adult, had my stroke at age 50 thirteen years ago. I'm going to live for a good long time yet, drinking wine and beer and doing stuff that any doctor would tell me was not ok.

Association of stroke among adults aged 18 to 49 years with long-term mortality

JAMA — Ekker MS, et al. | May 28, 2019

Researchers performed this Dutch register-based cohort study to determine the age- and sex-specific case fatality and long-term mortality associated with stroke among young adults. This study included 15,527 patients who had the first stroke between the ages 18 of 49 years in 1998-2010; they were followed up until January 1, 2017. Observations revealed that young adults who were 30-day survivors, continuously have elevated mortality risk up to 15 years after stroke.

Methods

The investigators identified patients and outcomes via linking the national Hospital Discharge Registry, national Cause of Death Registry, and the Dutch Population Register.
Exposures included first stroke occurring between the ages of 18 to 49 years, which were documented using International Classification of Diseases, Ninth Revision, and International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, codes for ischemic stroke, intracerebral hemorrhage, and stroke not otherwise specified.
As the primary outcome, 30-day survivors at end of follow-up were assessed for all-cause cumulative mortality stratified by age, sex, and stroke subtype.
Comparison to all-cause cumulative mortality in the general population was also done.

Results

At end of follow-up, over 3,500 cumulative deaths were reported, including 1,776 deaths within 30 days post-stroke and 1,764 deaths during a median duration of follow-up of 9.3 years
The 15-year mortality in 30-day survivors was 17.0% (95% CI: 16.2% to 17.9%).
Compared with the general population, the standardized mortality rate was 5.1 for ischemic stroke, and the standardized mortality rate for intracerebral hemorrhage was 8.4.(Whatever the hell this means, obviously not meant for lay persons.)