Increase in Stroke Hospitalizations Among Young People

A new study has found that a rising risk for stroke among young people, including children and teens, is being accompanied by a declining risk among the middle-aged and elderly.

Researchers from the US Centers for Disease Control and Prevention (CDC; Atlanta, GA, USA) and the Royal Children's Hospital (RCH; Melbourne, Australia) used the Nationwide Inpatient Sample (NIS)--the largest all-payer inpatient care database in the United States--to track trends in hospitalizations from 1994 to 2007. The researcher found increasing stroke-related hospitalizations in young patients, ranging from a 17% increase in females aged 15-34 years to a 51% increase in males aged 15-44 years. Surprisingly, a 35% increase was also noted in children aged 5-14 years of age.

Conversely, the researchers found a decline in stroke hospitalizations for older and younger age groups, with the decline in hospitalizations for babies and toddlers exceeded that of middle-aged and elderly patients. The decrease ranged from 51% in females younger than four years of age to an average 25% decrease in males aged 65 and older. The researchers pointed out the decline in hospitalizations for stroke among older people is consistent with other reports, and suggests that this confirms improvements in primary and secondary prevention and controlling of traditional risk factors. The study was published early online on February 11, 2011, in the Annals of Emergency Medicine.

"Stroke in children is rare, but it does exist. Stroke patients in our study had previously been generally healthy, unlike their adult counterparts. Because pediatric stroke is so rare, it's not the first thing we look for,” said lead author Franz Babl, MD, from the RCH. "Stroke symptoms in children are frequently attributed to other, more common problems, such as migraine, seizures, or encephalitis.”

"Acute ischemic stroke is currently considered something that mostly happens to older people,” added coauthor Xin Tong, MPH, a health statistician with the CDC's division for heart disease and stroke prevention. "But awareness of rising rates in the young is important or else tissue plasminogen activator and other important stroke treatment may be unnecessarily delayed in younger patients.”

The researchers suggest that the increase in hospitalizations may actually be related to better detection, such as the widespread use of magnetic resonance imaging (MRI) in identifying more cases, rather than a true incidence or rate of new strokes.

Related Links:
US Centers for Disease Control and Prevention
Royal Children's Hospital