ความชุกและสาเหตุของการเกิดโรคหลอดเลือดสมองขาดเลือดในผู้ป่วยอายุน้อย ในโรงพยาบาลพหลพลพยุหเสนา

Veerawan  Yoosomboon

Authors

Veerawan Yoosomboon Department of Medicine, Phaholpolpayuhasena Hospital, Kanchanaburi 71000

Keywords:

functional outcome, young adults, ischemic stroke, NIHSS

Abstract

Objectives: To investigate the prevalence, etiology, and factors associated with functional outcomes at 3 months among young adult patients with ischemic stroke.

Methods: This retrospective cohort study was conducted via medical record reviews of patients aged 15–45 years diagnosed with ischemic stroke and admitted to Phaholpolpayuhasena Hospital between January 1, 2022, and December 31, 2024. All eligible participants were included in the study. Data were analyzed using descriptive statistics and multiple logistic regression analysis.

Results: Among 152 young adult patients with ischemic stroke (3.10%), the mean age was 37.68±6.08 years, and 61.18% were male. Patients aged 15–39 years had a higher body mass index (27.83 ± 6.46 kg/m²) and a higher prevalence of substance use (33.33%), whereas those aged 40–45 years had a higher prevalence of diabetes mellitus (33.75%), hypertension (73.75%), and higher triglyceride levels (186.64±189.29 mg/dL). Small-vessel occlusion was the most common etiology (43.10%). At 3 months post-stroke, 73% of patients had favorable functional outcomes. The National Institutes of Health Stroke Scale (NIHSS) score on admission was the only factor associated with unfavorable functional outcomes (adjusted OR 1.30 per 1-point increase, 95% CI: 1.17–1.44).

Conclusions: The prevalence of ischemic stroke among young adult patients was 3.10%, primarily attributed by small-vessel occlusion linked to behavioral and metabolic risk factors. While most patients achieved favorable functional outcomes at 3 months, acute stroke severity remained the most critical determinant of long-term prognosis.

References

GBD 2019 Stroke Collaborators. Global, regional, and national burden of stroke and its risk factors, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Neurol. 2021;20(10):795–820. doi: 10.1016/S1474-4422(21)00252-0

Varona JF, Guerra JM, Bermejo F. Stroke in young adults. Med Clin (Barc). 2004;122(2):70–4. doi: 10.1016/s0025-7753(04)74145-7

Bukhari S, Yaghi S, Bashir Z. Stroke in young adults. J Clin Med. 2023;12(15):4999. doi: 10.3390/jcm12154999

Yahya T, Jilani MH, Khan SU, Mszar R, Hassan SZ, Blaha MJ, et al. Stroke in young adults: Current trends, opportunities for prevention and pathways forward. Am J Prev Cardiol. 2020;3:100085. doi: 10.1016/j.ajpc.2020.100085

George MG. Risk factors for ischemic stroke in younger adults. Stroke. 2020;51(3):729–35.

Stack CA, Cole JW. Clinical approach to stroke in young adults. In: Dehkharghani S, editor. Stroke. Brisbane (AU): Exon Publications; 2021. p. 53–78.

ศุจิพิชชา จันทรประภาพกุล, แสงเดือน มโยทาร, ศุภชาติ ชมพูนุช, สัญสนีย์ พงษ์ภักดี. ความชุกและสาเหตุของโรคสมองขาดเลือดในผู้ป่วยอายุน้อยในโรงพยาบาลภูมิพลอดุลยเดช. วารสารสมาคมโรคหลอดเลือดสมองไทย. 2561;17(3):5–14.

Hoffmann VS, Schönecker S, Amin M, Reidler P, Brauer A, Kopczak A, et al. A novel prediction score determining individual clinical outcome 3 months after juvenile stroke (PREDICT-score). J Neurol. 2024;271(9):6238-46. doi: 10.1007/s00415-024-12552-5

He Q, Wang M, Zhu H, Xiao Y, Wen R, Liu X, et al. Nomogram to predict 3 month prognosis of acute ischemic stroke among young adults. Front Neurol. 2025;15:1487248. doi: 10.3389/fneur.2024.1487248

Adams HP Jr, Bendixen BH, Kappelle LJ, Biller J, Love BB, Gordon DL, et al. Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment. Stroke. 1993;24(1):35–41. doi: 10.1161/01.STR.24.1.35

Perera KS, de Sa Boasquevisque D, Rao-Melacini P, Taylor A, Cheng A, Hankey GJ, et al. Evaluating rates of recurrent ischemic stroke among young adults with embolic stroke of undetermined source: The Young ESUS longitudinal cohort study. JAMA Neurol. 2022;79(5):450–8. doi: 10.1001/jamaneurol.2022.0048

Ekudomsuphan P, Dusitanond P. Prevalence and associated factors of ischemic stroke in the young patients. Thai Journal of Neurology. 2024;40(4):1–7.

Mbarek L, Chen S, Jin A, Pan Y, Meng X, Yang X, et al. Predicting 3-month poor functional outcomes of acute ischemic stroke in young patients using machine learning. Eur J Med Res. 2024;29(1):494.doi: 10.1186/s40001-024-02056-3

Sakseranee J, Sethabouppha P, Pattarasakulchai T, Klaewkla T, Thiankhaw K. The diagnostic tests and functional outcomes of acute ischemic stroke or transient ischemic attack in young adults: A 4-year hospital-based observational study. PLoS ONE. 2023;18(10):e0292274. doi: 10.1371/journal.pone.0292274

Kulkarni S, Faconti L, Partridge S, Delles C, Glover M, Lewis P, et al. Investigation and management of young-onset hypertension: British and Irish Hypertension Society position statement. J Hum Hypertens. 2024;38(7):544–54. doi:10.1038/s41371-024-00922-5

Walia SS, Ng K. Abstract WP207: Clinical Characteristics of Methamphetamine Associated Acute Ischemic Stroke. Stroke. 2019; 50(Suppl_1): WP207. doi: 10.1161/str.50.suppl_1.WP207

Powers WJ, Rabinstein AA, Ackerson T, Adeoye OM, Bambakidis NC, Becker K, et al. Guidelines for the Early Management of Patients With Acute Ischemic Stroke: 2019 Update to the 2018 Guidelines for the Early Management of Acute Ischemic Stroke. Stroke. 2019;50(12):e344–418. doi: 10.1161/STR.0000000000000211