Comparison of epidemiology, emergency care, and outcomes of acute ischemic stroke between young adults and elderly in Korean population: a multicenter observational study.

Stroke in young adults has been known to show a lower incidence and a better prognosis. Only a few studies have examined the epidemiology and outcomes of ischemic stroke in young adults and compared them with the elderly in Korean population. All consecutive patients with ischemic stroke visiting 29 participating emergency departments were enrolled from November 2007 to October 2009. Patients with less than 15 yr of age and unknown information on age and confirmed diagnosis were excluded. We categorized the patients into young adults (15 to 45 yr) and elderly (46 yr and older) groups. Of 39,156 enrolled all stroke patients, 25,818 with ischemic stroke were included and analyzed (young adult; n=1,431, 5.5%). Young adult patients showed lower prevalence of most chronic diseases but significantly higher prevalence in exercise, current smoking, and alcohol consumption. Hospital mortality was significantly lower in young adults than elderly (1.1% vs. 3.1%, P<0.001). Higher number of patients in elderly group (68.1%) showed worsening change of modified Rankin Scale than young adults (65.2%). Young adults ischemic stroke showed favorable hospital outcomes than the elderly in Korean population. Graphical Abstract Keywords: Stroke, Age Distribution, Epidemiology, Outcome Assessment INTRODUCTION Cerebrovascular disease is the second leading cause of death and the major cause of disability in Korea (1). Each year, about 105,000 Koreans experience a new or recurrent stroke and this number is estimated to rise up to 350,000 by 2030 (2). It has been considered that stroke frequently affects the elderly aged 55 yr or older, and rarely affects young adults aged between 15 and 45 yr (3, 4, 5, 6). Recent studies provide evidence that ischemic stroke in young adults is increasing worldwide (1). Although both prognosis and outcome of young adults stroke patients are better than those observed in older patients, stroke in younger adults has greater socioeconomic burden and quality of life consequences due to its longer duration than stroke in older adults (4, 7). Moreover, there are differences in etiologic and prognostic factors between young and old age stroke (6, 8). Until now, numerous studies have been conducted to identify etiology, risk factors, and prognostic factors of stroke in young adults, but most of these studies have been conducted in a single-institutional setting with small sample sizes (4, 5, 9, 10). Furthermore, most of these studies have examined both hemorrhagic stroke and ischemic stroke, and only few studies have compared the epidemiologic features, emergency care, and outcomes between young adults and the elderly. The objective of the present study was to examine demographics, epidemiologic features, emergency care, and outcomes of ischemic stroke in two age groups, young adults and the elderly in Korea.