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JC/temporal stroke.qmd

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+---
+title: "Neurologisk JC"
+subtitle: "Temporal Trends in Vascular Risk Factor Burden Among Young Adults With Ischemic Stroke"
+format: 
+  revealjs:
+    theme: serif
+      
+---
+
+
+## Background
+- Stroke is a leading cause of death and disability  
+- Traditionally considered a disease of older adults  
+- Rising stroke incidence among **young adults (18–55 years old)**  
+- Increasing **vascular risk factors (VRFs)** may be driving this trend  
+- Study aims to analyze **temporal trends in VRF burden** among young stroke patients  
+
+
+## Study Design & Data Source
+- **Prospective Cohort Study** using **Florida Stroke Registry (FSR)**  
+- Data collected from **2014–2022** across **172 hospitals**  
+- **Inclusion Criteria:**  
+  - Patients **18–55 years old** with **ischemic stroke (IS)**  
+- **Exclusion Criteria:**  
+  - Patients outside age range  
+  - Patients with **TIA, intracranial hemorrhage, or subarachnoid hemorrhage**  
+
+
+## Data Collection & Variables
+- Data obtained from **Get With The Guidelines-Stroke (GWTG-S)**  
+- **Demographics:**  
+  - Age, sex, race/ethnicity  
+- **Vascular Risk Factors (VRFs):**  
+  - Hypertension, dyslipidemia, obesity, diabetes, smoking  
+  - Atrial fibrillation, coronary artery disease, heart failure, sleep apnea  
+- **Polymorbidity:** Defined as **3 or more VRFs**  
+
+
+## Statistical Analysis
+- **Comparative Analysis:**  
+  - Continuous variables: **t-test / Wilcoxon-Mann-Whitney**  
+  - Categorical variables: **Chi-square test**  
+- **Temporal Trends Analysis:**  
+  - VRF trends assessed across study period  
+
+
+## Main Results
+- **Total patients analyzed:** 36,488  
+- **Age breakdown:**
+  - 18–35 years: **3,363 patients (9.2%)**  
+  - 36–55 years: **33,125 patients (90.8%)**  
+  
+##
+- **Key Findings:**
+  - **Polymorbidity (≥3 VRFs) increased** over time:  
+    - **18–35 years:** 10.9% → 16.4% (p = 0.002)  
+    - **36–55 years:** 34.6% → 41.9% (p < 0.001)  
+  - **Higher VRF burden in**:
+    - **Non-Hispanic Black** patients
+    - **Male** patients  
+  - **Most common VRFs:** Hypertension, obesity, diabetes  
+
+
+## Strengths of the Study
+✅ **Large, diverse cohort** from a statewide registry  
+✅ **Standardized data collection** via GWTG-S  
+✅ **Analyzed temporal trends** in VRFs  
+✅ **Examined racial & sex disparities** in VRF burden  
+
+
+
+## Study Limitations
+❌ **Limited generalizability** (Florida hospitals only)  
+❌ **No stroke etiology data** (high missingness)  
+❌ **Unknown VRF severity & management** (no treatment data)  
+❌ **Potential bias in VRF reporting** (better diagnosis over time)  
+❌ **Lack of socioeconomic data** (income, education, access to care)  
+
+
+
+## Conclusion
+- **VRF burden is increasing** in young adults with stroke  
+- **Disparities exist**—higher polymorbidity in **Black and male patients**  
+- **Early identification & prevention strategies** are crucial  
+- **Future research** should focus on **stroke etiology & socioeconomic factors**  
+
+