An international perspective on young stroke incidence and risk factors: a scoping review.
Age group standardisation
Epidemiology
Global
Paediatric stroke
Perinatal stroke
Risk factors
Under 30 years
Journal
BMC public health
ISSN: 1471-2458
Titre abrégé: BMC Public Health
Pays: England
ID NLM: 100968562
Informations de publication
Date de publication:
18 Jun 2024
18 Jun 2024
Historique:
received:
11
05
2023
accepted:
13
06
2024
medline:
19
6
2024
pubmed:
19
6
2024
entrez:
18
6
2024
Statut:
epublish
Résumé
Stroke among younger age groups is increasing globally. While there is a focus on research conducted on people under 65 years who have had a stroke, there is a paucity of data on the incidence and risk factors of stroke among younger people (≤ 30 years). This scoping review examines evidence on incidence and risk factors for perinatal, paediatric and young adult stroke globally. The review was guided by the Joanna Briggs Institute's scoping review methodology. A systematic search was conducted on 23rd March 2022 across Medline Ovid, Embase, PsycINFO and Cumulative Index to Nursing and Allied Health Literature (CINAHL). The eligibility criteria included all study designs providing information on the incidence and risk factors of stroke among young people (≤ 30 years) in the last ten years. A total of 5750 articles were identified. After screening, 471 articles (224 cohort studies (47.6%), 164 case studies/case series (34.8%), 35 reviews (7.4%), 30 case-control (6.4%) and 18 combinations of designs (3.8%) were included. There was data from 50 different countries, 199 studies were from high-income countries, upper and middle income (n = 38), lower middle-income (n = 39), low-income (n = 3) countries, international study (n = 7) and a further 185 articles did not state the country of research. Most of the studies (63%) focused on risk factors while incidence constituted 37%. Incidence data were reported heterogeneously across studies, leading to an inability to synthesise data. The three most frequently reported risk factors for perinatal stroke were infections, cardiac conditions, and intrapartum factors. Vasculopathies, infection and cardiac conditions accounted for most reported risk factors for paediatric stroke, while chronic conditions such as diabetes mellitus, vasculopathies and cardiac conditions accounted for the most reported risk factors among young adults. This review has highlighted different stroke risk factors for each age cohort of people under 30 years. The low number of epidemiological studies suggests that further research of this type is needed to fully understand the incidence and risk factors in young stroke. A standardised reporting of age groupings of incidence data is imperative to enable the comparison of data from different geographical locations.
Sections du résumé
BACKGROUND
BACKGROUND
Stroke among younger age groups is increasing globally. While there is a focus on research conducted on people under 65 years who have had a stroke, there is a paucity of data on the incidence and risk factors of stroke among younger people (≤ 30 years). This scoping review examines evidence on incidence and risk factors for perinatal, paediatric and young adult stroke globally.
METHODS
METHODS
The review was guided by the Joanna Briggs Institute's scoping review methodology. A systematic search was conducted on 23rd March 2022 across Medline Ovid, Embase, PsycINFO and Cumulative Index to Nursing and Allied Health Literature (CINAHL). The eligibility criteria included all study designs providing information on the incidence and risk factors of stroke among young people (≤ 30 years) in the last ten years.
RESULTS
RESULTS
A total of 5750 articles were identified. After screening, 471 articles (224 cohort studies (47.6%), 164 case studies/case series (34.8%), 35 reviews (7.4%), 30 case-control (6.4%) and 18 combinations of designs (3.8%) were included. There was data from 50 different countries, 199 studies were from high-income countries, upper and middle income (n = 38), lower middle-income (n = 39), low-income (n = 3) countries, international study (n = 7) and a further 185 articles did not state the country of research. Most of the studies (63%) focused on risk factors while incidence constituted 37%. Incidence data were reported heterogeneously across studies, leading to an inability to synthesise data. The three most frequently reported risk factors for perinatal stroke were infections, cardiac conditions, and intrapartum factors. Vasculopathies, infection and cardiac conditions accounted for most reported risk factors for paediatric stroke, while chronic conditions such as diabetes mellitus, vasculopathies and cardiac conditions accounted for the most reported risk factors among young adults.
CONCLUSION
CONCLUSIONS
This review has highlighted different stroke risk factors for each age cohort of people under 30 years. The low number of epidemiological studies suggests that further research of this type is needed to fully understand the incidence and risk factors in young stroke. A standardised reporting of age groupings of incidence data is imperative to enable the comparison of data from different geographical locations.
Identifiants
pubmed: 38890645
doi: 10.1186/s12889-024-19134-0
pii: 10.1186/s12889-024-19134-0
doi:
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
1627Informations de copyright
© 2024. The Author(s).
Références
Johnson CO, et al. Global, regional, and national burden of stroke, 1990–2016: a systematic analysis for the global burden of Disease Study 2016. Lancet Neurol. 2019;18(5):439–58.
doi: 10.1016/S1474-4422(19)30034-1
Béjot Y, et al. Trends in the incidence of ischaemic stroke in young adults between 1985 and 2011: the Dijon Stroke Registry. J Neurol Neurosurg Psychiatry. 2014;85(5):509–13.
doi: 10.1136/jnnp-2013-306203
pubmed: 24249786
Ekker MS, et al. Stroke incidence in young adults according to age, subtype, sex, and time trends. Neurology. 2019;92(21):e2444–54.
doi: 10.1212/WNL.0000000000007533
pubmed: 31019103
Griffiths D, Sturm J. Epidemiology and etiology of Young Stroke. Stroke Res Treat. 2011;2011:1–9.
doi: 10.4061/2011/209370
Leung LY, Melkumova E, Thaler DE. Longitudinal care for young adults with stroke. JAMA Neurol. 2017;74(10):1163–4.
doi: 10.1001/jamaneurol.2017.1874
pubmed: 28828467
Wong HJ, et al. Health-related quality of life profiles and their dimension-specific associated factors among Malaysian stroke survivors: a cross sectional study. Volume 19. Health and Quality of Life Outcomes; 2021. 1.
Röding J, et al. Frustrated and invisible–younger stroke patients’ experiences of the rehabilitation process. Disabil Rehabil. 2003;25(15):867–74.
doi: 10.1080/0963828031000122276
pubmed: 12851097
Aarnio K, et al. Return to work after ischemic stroke in young adults: a registry-based follow-up study. Neurology. 2018;91(20):e1909–17.
doi: 10.1212/WNL.0000000000006510
pubmed: 30315074
pmcid: 6260196
Alaszewski A, et al. Working after a stroke: survivors’ experiences and perceptions of barriers to and facilitators of the return to paid employment. Disabil Rehabil. 2007;29(24):1858–69.
doi: 10.1080/09638280601143356
pubmed: 17852252
Hajek CA, et al. Cognitive outcomes following arterial ischemic stroke in infants and children. J Child Neurol. 2014;29(7):887–94.
doi: 10.1177/0883073813491828
pubmed: 23760990
Cooper AN et al. Trajectories of Motor Recovery in the First Year after Pediatric arterial ischemic stroke. Pediatrics, 2017. 140(2).
Virani SS, et al. Heart disease and stroke statistics—2020 update: a report from the American Heart Association. Circulation. 2020;141(9):e139–596.
doi: 10.1161/CIR.0000000000000757
pubmed: 31992061
Australia Institute of Health and, Welfare A. Disease expenditure in Australia. Cat. no. HWE 76. 2019 [cited 2021 19th July 2021]; 2019b]. https://www.aihw.gov.au/reports/health-welfare-expenditure/disease-expenditure-australia/data .
Wang G, et al. Costs of hospitalization for stroke patients aged 18–64 years in the United States. J Stroke Cerebrovasc Dis. 2014;23(5):861–8.
doi: 10.1016/j.jstrokecerebrovasdis.2013.07.017
pubmed: 23954598
Brown DL, et al. Projected costs of ischemic stroke in the United States. Neurology. 2006;67(8):1390–5.
doi: 10.1212/01.wnl.0000237024.16438.20
pubmed: 16914694
Australia Institute of Health and Welfare. A. Disease expenditure in Australia 2018-19 2019 26/4/2024]; https://www.aihw.gov.au/reports/health-welfare-expenditure/disease-expenditure-australia/data .
O’Hana SNC. Preferences of Young Stroke survivors to meet their unique needs: it is time to listen. Neurology. 2021;96(13):e1809–11.
Shipley J, et al. How can stroke care be improved for younger service users? A qualitative study on the unmet needs of younger adults in inpatient and outpatient stroke care in Australia. Disabil Rehabil. 2020;42(12):1697–704.
doi: 10.1080/09638288.2018.1534278
pubmed: 30616439
Keating J, et al. Young Stroke survivors’ Preferred methods of Meeting their unique needs: shaping Better Care. Neurology. 2021;96(13):e1701–10.
doi: 10.1212/WNL.0000000000011647
pubmed: 33568545
Opoku S, Eliason C, Akpalu A. Why me? A qualitative study on the experiences of Young Stroke survivors in the Accra Metropolis of Ghana, West Africa. J Patient Exp. 2020;7(6):1788–96.
doi: 10.1177/2374373520967505
pubmed: 33457644
pmcid: 7786678
Sadler E, et al. Navigating stroke care: the experiences of younger stroke survivors. Disabil Rehabil. 2014;36(22):1911–7.
doi: 10.3109/09638288.2014.882416
pubmed: 24467678
Harris Walker G, et al. Recovery experiences of younger stroke survivors who are parents: a qualitative content analysis. J Clin Nurs. 2021;30(1–2):126–35.
doi: 10.1111/jocn.15529
pubmed: 33031618
Glozier N, et al. The Course and Impact of Poststroke Insomnia in Stroke survivors aged 18 to 65 years: results from the Psychosocial outcomes in StrokE (POISE) study. Cerebrovasc Dis Extra. 2017;7(1):9–20.
doi: 10.1159/000455751
pubmed: 28161702
pmcid: 5346918
Renna R, et al. Risk factor and etiology analysis of ischemic stroke in young adult patients. J Stroke Cerebrovasc Dis. 2014;23(3):e221–7.
doi: 10.1016/j.jstrokecerebrovasdis.2013.10.008
pubmed: 24418315
Stroke Foundation of Australia. Chidlhood stroke. 2021 [cited 2021 5/07/2021]; https://strokefoundation.org.au/About-Stroke/Learn/Childhood-stroke .
Ferriero DM, et al. Management of stroke in neonates and children: A Scientific Statement from the American Heart Association/American Stroke Association. Stroke. 2019;50(3):e51–96.
doi: 10.1161/STR.0000000000000183
pubmed: 30686119
Asakai H, et al. Arterial ischemic stroke in children with cardiac disease. Neurology. 2015;85(23):2053–9.
doi: 10.1212/WNL.0000000000002036
pubmed: 26408496
pmcid: 4676756
Arksey H, O’Malley L. Scoping studies: towards a methodological framework. Int J Soc Res Methodol. 2005;8(1):19–32.
doi: 10.1080/1364557032000119616
Tricco AC, et al. PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med. 2018;169(7):467–73.
doi: 10.7326/M18-0850
pubmed: 30178033
Peters MDJ, McInerney GC, Munn P, Tricco Z, Khalil AC. H. Chapter 11: Scoping Reviews (2020 version). JBI Manual for Evidence Synthesis 2020 11th May 2023]; https://jbi-global-wiki.refined.site/space/MANUAL .
The World Bank. The World by Income and Region. 2020 [cited 2022 28th February 2022]; https://datatopics.worldbank.org/world-development-indicators/the-world-by-income-and-region.html .
Australia Institute of Health and Welfare. A. Risk factors- Overview. n.d; https://www.aihw.gov.au/reports-data/behaviours-risk-factors/risk-factors/overview .
White F. Application of Disease etiology and natural history to Prevention in Primary Health Care: a discourse. Med Principles Pract. 2020;29(6):501–13.
doi: 10.1159/000508718
McCavit TL, et al. National trends in incidence rates of hospitalization for stroke in children with sickle cell disease. Pediatr Blood Cancer. 2013;60(5):823–7.
doi: 10.1002/pbc.24392
pubmed: 23151905
Moiz B, et al. Case Study of Pediatric cerebral sinus venous thrombosis Center of a low Middle-Income Country. Volume 27. Clinical & Applied Thrombosis/Hemostasis; 2021. p. 10760296211022847.
Engle R, Ellis C. Pediatric stroke in the U.S.: estimates from the kids’ inpatient database 2012. 1(3): pp. e63-7.
Gandhi SK, et al. Temporal trends in incidence and long-term case fatality of stroke among children from 1994 to 2007. Neurology. 2012;78(24):1923–9.
doi: 10.1212/WNL.0b013e318259e25c
pubmed: 22649219
Champaloux SW, et al. Use of combined hormonal contraceptives among women with migraines and risk of ischemic stroke. Am J Obstet Gynecol. 2017;216(5):e4891–7.
doi: 10.1016/j.ajog.2016.12.019
Mallick AA, et al. Childhood arterial ischaemic stroke incidence, presenting features, and risk factors: a prospective population-based study. Lancet Neurol. 2014;13(1):35–43.
doi: 10.1016/S1474-4422(13)70290-4
pubmed: 24304598
Nasreen S, et al. Background incidence rates of hospitalisations and emergency department visits for thromboembolic and coagulation disorders in Ontario, Canada for COVID-19 vaccine safety assessment: a population-based retrospective observational study. BMJ Open. 2021;11(12):e052019.
doi: 10.1136/bmjopen-2021-052019
pubmed: 34921078
Maredza M, Bertram MY, Tollman SM. Disease burden of stroke in rural South Africa: an estimate of incidence, mortality and disability adjusted life years. BMC Neurol. 2015;15(1):54–54.
doi: 10.1186/s12883-015-0311-7
pubmed: 25880843
pmcid: 4396076
Yesilot Barlas N et al. Etiology of first-ever ischaemic stroke in European young adults: the 15 cities young stroke study. Eur J Neurol, 2013: p. n/a-n/a.
Ferro JM, Massaro AR, Mas J-L. Aetiological diagnosis of ischaemic stroke in young adults. Lancet Neurol. 2010;9(11):1085–96.
doi: 10.1016/S1474-4422(10)70251-9
pubmed: 20965437
Ekker MS, et al. Risk factors and causes of ischemic stroke in 1322 young adults. Stroke. 2023;54(2):439–47.
doi: 10.1161/STROKEAHA.122.040524
pubmed: 36511150
Zhao Y, et al. Increasing burden of stroke in China: a systematic review and meta-analysis of prevalence, incidence, mortality, and case fatality. Int J Stroke. 2022;18(3):259–67.
doi: 10.1177/17474930221135983
pubmed: 36274585
Boot E, et al. Ischaemic stroke in young adults: a global perspective. J Neurol Neurosurg Psychiatry. 2020;91(4):411–7.
doi: 10.1136/jnnp-2019-322424
pubmed: 32015089
Higgins J, Green S. When not to use meta-analysis in a review. Cochrane Handbook for Systematic Reviews of Interventions 8.1. 2 [updated May 2005]; Sect. 8 The Cochrane Library, 2005(3).
Owolabi MO, et al. The state of stroke services across the globe: report of World Stroke Organization–World Health Organization surveys. Int J Stroke. 2021;16(8):889–901.
doi: 10.1177/17474930211019568
pubmed: 33988062
pmcid: 8800855
Krishnamurthi RV, Ikeda T, Feigin VL. Global, Regional and Country-Specific Burden of Ischaemic Stroke, Intracerebral Haemorrhage and Subarachnoid Haemorrhage: a systematic analysis of the global burden of Disease Study 2017. Neuroepidemiology. 2020;54(2):171–9.
doi: 10.1159/000506396
pubmed: 32079017
Jacob MA, et al. Global differences in risk factors, etiology, and outcome of ischemic stroke in young Adults—A Worldwide Meta-analysis. Neurology. 2022;98(6):e573–88.
doi: 10.1212/WNL.0000000000013195
pubmed: 34906974
pmcid: 8829964
Nissen T, Wynn R. The clinical case report: a review of its merits and limitations. BMC Res Notes. 2014;7(1):264.
doi: 10.1186/1756-0500-7-264
pubmed: 24758689
pmcid: 4001358
Guidelines to writing a clinical case report. Heart Views, 2017. 18(3): p. 104–5.
Pham MT, et al. A scoping review of scoping reviews: advancing the approach and enhancing the consistency. Res Synthesis Methods. 2014;5(4):371–85.
doi: 10.1002/jrsm.1123