Characteristics and Outcomes of Younger Adults with Embolic Stroke of Undetermined Source (ESUS): A Retrospective Study
Introduction. Embolic stroke of undetermined source (ESUS) in younger adults may have different risk factors compared with ESUS in elderly, and the approach to ESUS in young adults may require new therapies. We aimed to investigate the characteristics and outcomes in younger adults with ESUS at a si...
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| Format: | Article |
| Language: | English |
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Wiley
2019-01-01
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| Series: | Stroke Research and Treatment |
| Online Access: | http://dx.doi.org/10.1155/2019/4360787 |
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| author | Ali M. Al Khathaami Bayan Al Bdah Abdulmjeed Alnosair Abdulkarim Alturki Rayan Alrebdi Shorug Alwayili Sulaiman Alhamzah Fahad A. M. AlKhathaami Nasser Alotaibi |
| author_facet | Ali M. Al Khathaami Bayan Al Bdah Abdulmjeed Alnosair Abdulkarim Alturki Rayan Alrebdi Shorug Alwayili Sulaiman Alhamzah Fahad A. M. AlKhathaami Nasser Alotaibi |
| author_sort | Ali M. Al Khathaami |
| collection | DOAJ |
| description | Introduction. Embolic stroke of undetermined source (ESUS) in younger adults may have different risk factors compared with ESUS in elderly, and the approach to ESUS in young adults may require new therapies. We aimed to investigate the characteristics and outcomes in younger adults with ESUS at a single centre in Saudi Arabia. Patients and Methods. A retrospective study was conducted using the medical records of younger adults with ESUS according to the criteria of the Cryptogenic Stroke/ESUS International Working Group. Younger adults (aged ≤50 years) with ESUS were compared with older patients, on admission and discharge from hospital, using the modified Rankin scale (mRS) and the National Institute of Health Stroke Scale (NIHSS). Results. Among 147 patients with ESUS, 39 (26.5%) were younger adults. Younger adults compared with older adults with ESUS had fewer vascular risk factors, including lower rates of hypertension (43.6% vs. 70.3%; P=0.004), diabetes (35.9% vs. 57.4%; P=0.03), and dyslipidaemia (12.8% vs. 28.7%; P=0.05). There was no significant difference in poor outcome at discharge (defined as mRS > 2), which was observed in 17.9% of younger adults and 28.7% of older adults. Further, there were no significant differences in stroke severity at discharge (NIHSS score ≤5) or median length of stay. Discussion. Although the outcomes of ESUS do not differ between younger and older patients, younger patients have fewer identified risk factors. Conclusion. This study showed that 26.5% of patients with ESUS were aged ≤50 years. Although younger adults with ESUS had fewer risk factors, there were no significant differences in neurologic disability or mortality at discharge, stroke severity, or median length of stay. |
| format | Article |
| id | doaj-art-d73ebf62bc984144b73ae9151c9e648a |
| institution | Kabale University |
| issn | 2090-8105 2042-0056 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Stroke Research and Treatment |
| spelling | doaj-art-d73ebf62bc984144b73ae9151c9e648a2025-02-03T01:00:30ZengWileyStroke Research and Treatment2090-81052042-00562019-01-01201910.1155/2019/43607874360787Characteristics and Outcomes of Younger Adults with Embolic Stroke of Undetermined Source (ESUS): A Retrospective StudyAli M. Al Khathaami0Bayan Al Bdah1Abdulmjeed Alnosair2Abdulkarim Alturki3Rayan Alrebdi4Shorug Alwayili5Sulaiman Alhamzah6Fahad A. M. AlKhathaami7Nasser Alotaibi8King Abdulaziz Medical City, National Guard Health Affairs, Riyadh, Saudi ArabiaKing Abdullah International Medical Research Center, Saudi ArabiaKing Abdullah International Medical Research Center, Saudi ArabiaKing Abdullah International Medical Research Center, Saudi ArabiaKing Abdullah International Medical Research Center, Saudi ArabiaKing Abdullah International Medical Research Center, Saudi ArabiaKing Abdullah International Medical Research Center, Saudi ArabiaCollege of Medicine, King Saud Bin Abdul Aziz University for Health Sciences, Riyadh, Saudi ArabiaKing Abdulaziz Medical City, National Guard Health Affairs, Riyadh, Saudi ArabiaIntroduction. Embolic stroke of undetermined source (ESUS) in younger adults may have different risk factors compared with ESUS in elderly, and the approach to ESUS in young adults may require new therapies. We aimed to investigate the characteristics and outcomes in younger adults with ESUS at a single centre in Saudi Arabia. Patients and Methods. A retrospective study was conducted using the medical records of younger adults with ESUS according to the criteria of the Cryptogenic Stroke/ESUS International Working Group. Younger adults (aged ≤50 years) with ESUS were compared with older patients, on admission and discharge from hospital, using the modified Rankin scale (mRS) and the National Institute of Health Stroke Scale (NIHSS). Results. Among 147 patients with ESUS, 39 (26.5%) were younger adults. Younger adults compared with older adults with ESUS had fewer vascular risk factors, including lower rates of hypertension (43.6% vs. 70.3%; P=0.004), diabetes (35.9% vs. 57.4%; P=0.03), and dyslipidaemia (12.8% vs. 28.7%; P=0.05). There was no significant difference in poor outcome at discharge (defined as mRS > 2), which was observed in 17.9% of younger adults and 28.7% of older adults. Further, there were no significant differences in stroke severity at discharge (NIHSS score ≤5) or median length of stay. Discussion. Although the outcomes of ESUS do not differ between younger and older patients, younger patients have fewer identified risk factors. Conclusion. This study showed that 26.5% of patients with ESUS were aged ≤50 years. Although younger adults with ESUS had fewer risk factors, there were no significant differences in neurologic disability or mortality at discharge, stroke severity, or median length of stay.http://dx.doi.org/10.1155/2019/4360787 |
| spellingShingle | Ali M. Al Khathaami Bayan Al Bdah Abdulmjeed Alnosair Abdulkarim Alturki Rayan Alrebdi Shorug Alwayili Sulaiman Alhamzah Fahad A. M. AlKhathaami Nasser Alotaibi Characteristics and Outcomes of Younger Adults with Embolic Stroke of Undetermined Source (ESUS): A Retrospective Study Stroke Research and Treatment |
| title | Characteristics and Outcomes of Younger Adults with Embolic Stroke of Undetermined Source (ESUS): A Retrospective Study |
| title_full | Characteristics and Outcomes of Younger Adults with Embolic Stroke of Undetermined Source (ESUS): A Retrospective Study |
| title_fullStr | Characteristics and Outcomes of Younger Adults with Embolic Stroke of Undetermined Source (ESUS): A Retrospective Study |
| title_full_unstemmed | Characteristics and Outcomes of Younger Adults with Embolic Stroke of Undetermined Source (ESUS): A Retrospective Study |
| title_short | Characteristics and Outcomes of Younger Adults with Embolic Stroke of Undetermined Source (ESUS): A Retrospective Study |
| title_sort | characteristics and outcomes of younger adults with embolic stroke of undetermined source esus a retrospective study |
| url | http://dx.doi.org/10.1155/2019/4360787 |
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