BACKGROUND AND PURPOSE: Our population-based long-term follow-up of young ischaemic stroke patients and controls showed 10-fold increased mortality and fivefold increased arterial event rate nearly 12 years after study inclusion. We now assess memory, anxiety, depression and sleep in relation to employment and functional outcome, treatment goals and results from a last alive-dead survey. METHODS: Patients (n = 232) ≤ 49 years with an index-stroke between 1988 and 1997 were retrospectively selected and compared with age- and sex-matched controls (n = 453). At follow-up from 2004 to 2005, 144 (77%) of 187 patients were clinically examined. Self-assessment information about memory problems, anxiety, depression, sleeping problems, education and employment was compared with answers from standardized questionnaires from 167 controls. Functional outcome was measured by the modified Rankin Scale (mRS). RESULTS: Patients compared with controls had more memory problems (41.0% vs. 5.4%, P < 0.001), anxiety (19.4% vs. 9%, P = 0.009), depression (29.2% vs. 13.2%, P = 0.001) and sleeping problems (36.1% vs. 19.2%, P = 0.001). In the multiple regression analysis male gender (OR 9.3, 95%CI 0.10-0.61, P = 0.002), normal memory (OR 12.7, 95%CI 0.07-0.47, P < 0.001) and mRS 0-1 (OR 15.7, 95%CI 0.002-0.12, P < 0.001) were factors for full-time employment. Blood pressure was < 140/90 mmHg in 39% of patients, 49% stopped smoking and 38.2% used statins. After a mean observation time of 18.3 years, 63 (27.2%) of 232 patients were dead. CONCLUSIONS: Our data show a heterogeneous prognosis and high mortality even for long-time survivors of ischaemic stroke at a young age. Prospective studies of young stroke patients and controls are necessary for direct comparison.
BACKGROUND AND PURPOSE: Our population-based long-term follow-up of young ischaemic strokepatients and controls showed 10-fold increased mortality and fivefold increased arterial event rate nearly 12 years after study inclusion. We now assess memory, anxiety, depression and sleep in relation to employment and functional outcome, treatment goals and results from a last alive-dead survey. METHODS:Patients (n = 232) ≤ 49 years with an index-stroke between 1988 and 1997 were retrospectively selected and compared with age- and sex-matched controls (n = 453). At follow-up from 2004 to 2005, 144 (77%) of 187 patients were clinically examined. Self-assessment information about memory problems, anxiety, depression, sleeping problems, education and employment was compared with answers from standardized questionnaires from 167 controls. Functional outcome was measured by the modified Rankin Scale (mRS). RESULTS:Patients compared with controls had more memory problems (41.0% vs. 5.4%, P < 0.001), anxiety (19.4% vs. 9%, P = 0.009), depression (29.2% vs. 13.2%, P = 0.001) and sleeping problems (36.1% vs. 19.2%, P = 0.001). In the multiple regression analysis male gender (OR 9.3, 95%CI 0.10-0.61, P = 0.002), normal memory (OR 12.7, 95%CI 0.07-0.47, P < 0.001) and mRS 0-1 (OR 15.7, 95%CI 0.002-0.12, P < 0.001) were factors for full-time employment. Blood pressure was < 140/90 mmHg in 39% of patients, 49% stopped smoking and 38.2% used statins. After a mean observation time of 18.3 years, 63 (27.2%) of 232 patients were dead. CONCLUSIONS: Our data show a heterogeneous prognosis and high mortality even for long-time survivors of ischaemic stroke at a young age. Prospective studies of young strokepatients and controls are necessary for direct comparison.
Authors: Barbara Goeggel Simonetti; Marie-Luise Mono; Uyen Huynh-Do; Patrik Michel; Celine Odier; Roman Sztajzel; Philippe Lyrer; Stefan T Engelter; Leo Bonati; Henrik Gensicke; Christopher Traenka; Barbara Tettenborn; Bruno Weder; Urs Fischer; Aekaterini Galimanis; Simon Jung; Rudolf Luedi; Gian Marco De Marchis; Anja Weck; Carlo W Cereda; Ralf Baumgartner; Claudio L Bassetti; Heinrich P Mattle; Krassen Nedeltchev; Marcel Arnold Journal: J Neurol Date: 2015-06-12 Impact factor: 4.849
Authors: Noortje A M M Maaijwee; Loes C A Rutten-Jacobs; Pauline Schaapsmeerders; Ewoud J van Dijk; Frank-Erik de Leeuw Journal: Nat Rev Neurol Date: 2014-04-29 Impact factor: 42.937
Authors: Jani Pirinen; Jukka Putaala; Karoliina Aarnio; Aapo L Aro; Satu Mustanoja; Juha Sinisalo; Markku Kaste; Elena Haapaniemi; Turgut Tatlisumak; Mika Lehto Journal: Eur Stroke J Date: 2017-03-01
Authors: Jukka Putaala; Nicolas Martinez-Majander; Sahrai Saeed; Nilufer Yesilot; Pekka Jäkälä; Ossi Nerg; Georgios Tsivgoulis; Heikki Numminen; Daniel Gordin; Bettina von Sarnowski; Ulrike Waje-Andreassen; Pauli Ylikotila; Risto O Roine; Marialuisa Zedde; Juha Huhtakangas; Catarina Fonseca; Petra Redfors; Frank-Erik de Leeuw; Alessandro Pezzini; Janika Kõrv; Siim Schneider; Christian Tanislav; Christian Enzinger; Dalius Jatuzis; Bob Siegerink; Patricia Martínez-Sánchez; Armin J Grau; Frederick Palm; Per-Henrik Groop; Sylvain Lanthier; Hugo Ten Cate; Pirkko Pussinen; Susanna Paju; Juha Sinisalo; Mika Lehto; Arne Lindgren; José Ferro; Steven Kittner; Franz Fazekas; Eva Gerdts; Turgut Tatlisumak Journal: Eur Stroke J Date: 2017-04-04