PAaSO/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**