Lars Kellert1,2, Armin Grau3, Alessandro Pezzini4, Stéphanie Debette5,6, Didier Leys7, Valeria Caso8, Vincent N Thijs9,10, Anna Bersano9, Emmanuel Touzé10, Turgut Tatlisumak11,12, Christopher Traenka13, Philippe A Lyrer14,15, Stefan T Engelter13,16, Tiina M Metso17, Caspar Grond-Ginsbach18, Manja Kloss18. 1. Department of Neurology, Ludwig Maximilians University, Marchioninistrasse 15, 81377, Munich, Germany. Lars.Kellert@med.uni-muenchen.de. 2. Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany. Lars.Kellert@med.uni-muenchen.de. 3. Department of Neurology, Klinikum Ludwigshafen, Ludwigshafen, Germany. 4. Department of Clinical and Experimental Sciences, Neurology Clinic, University of Brescia, Brescia, Italy. 5. Inserm, Bordeaux Population Health Research Center, UMR 1219, CHU Bordeaux, University of Bordeaux, 33000, Bordeaux, France. 6. Department of Neurology-Memory Clinic, Bordeaux University Hospital, 146 rue Léo Saignat, 33076, Bordeaux, France. 7. Department of Neurology, INSERM U 1171, Degenerative and Vascular Cognitive Disorders, CHU Lille, University of Lille, 59000, Lille, France. 8. Stroke Unit, Perugia University Hospital, Perugia, Italy. 9. Cerebrovascular Unit IRCCS Foundation C.Besta Neurological Institute, via Celoria 11, Milan, Italy. 10. Department of Neurology, University of Caen Basse Normandie, INSERM U919, CHU Côte de Nacre, Caen, France. 11. Department of Clinical Neurosciences, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden. 12. Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden. 13. Department of Neurology, Basel University Hospital, University of Basel, Basel, Switzerland. 14. Stroke Division, Florey Institute of Neuroscience and Mental Health, The University of Melbourne Heidelberg, Heidelberg, VIC, Australia. 15. Department of Neurology, Austin Health, Heidelberg, VIC, Australia. 16. Neurorehabilitation Unit, University Center for Medicine of Aging and Rehabilitation, University of Basel, Felix Platter Hospital, Basel, Switzerland. 17. Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland. 18. Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany.
Abstract
BACKGROUND AND PURPOSE: We investigated whether university education is more likely in cervical artery dissection (CeAD)-patients than in age- and sex-matched patients with ischemic stroke (IS) due to other causes (non-CeAD-IS-patients). METHODS: Patients from the Cervical Artery Dissection and Ischemic Stroke Patients study with documented self-reported profession before onset of IS due to CeAD (n = 715) or non-CeAD causes (n = 631) were analyzed. In the reported profession, the absence or presence of university education was assessed. Professions could be rated as academic or non-academic in 518 CeAD and 456 non-CeAD patients. Clinical outcome at 3 months was defined as excellent if modified Rankin Scale was 0-1. RESULTS: University education was more frequent in CeAD-patients (100 of 518, 19.3%) than in non-CeAD-IS-patients (61 of 456, 13.4%, p = 0.008). CeAD-patients with and without university education differed significantly with regard to smoking (39 vs. 57%, p = 0.001) and excellent outcome (80 vs. 66%, p = 0.004). In logistic regression analysis, university education was associated with excellent outcome in CeAD-patients (OR 2.44, 95% CI 1.37-5.38) independent of other outcome predictors such as age (OR 0.97, 95% CI 0.84-0.99), NIHSS (OR 0.80, 95% CI 0.76-0.84) and local signs (OR 2.77, 95% CI 1.37-5.57). CONCLUSION: We observed a higher rate of university education in patients with CeAD compared with non-CeAD patients in our study population. University education was associated with favorable outcome in CeAD-patients. The mechanism behind this association remains unclear.
BACKGROUND AND PURPOSE: We investigated whether university education is more likely in cervical artery dissection (CeAD)-patients than in age- and sex-matched patients with ischemic stroke (IS) due to other causes (non-CeAD-IS-patients). METHODS:Patients from the Cervical Artery Dissection and Ischemic StrokePatients study with documented self-reported profession before onset of IS due to CeAD (n = 715) or non-CeAD causes (n = 631) were analyzed. In the reported profession, the absence or presence of university education was assessed. Professions could be rated as academic or non-academic in 518 CeAD and 456 non-CeAD patients. Clinical outcome at 3 months was defined as excellent if modified Rankin Scale was 0-1. RESULTS: University education was more frequent in CeAD-patients (100 of 518, 19.3%) than in non-CeAD-IS-patients (61 of 456, 13.4%, p = 0.008). CeAD-patients with and without university education differed significantly with regard to smoking (39 vs. 57%, p = 0.001) and excellent outcome (80 vs. 66%, p = 0.004). In logistic regression analysis, university education was associated with excellent outcome in CeAD-patients (OR 2.44, 95% CI 1.37-5.38) independent of other outcome predictors such as age (OR 0.97, 95% CI 0.84-0.99), NIHSS (OR 0.80, 95% CI 0.76-0.84) and local signs (OR 2.77, 95% CI 1.37-5.57). CONCLUSION: We observed a higher rate of university education in patients with CeAD compared with non-CeAD patients in our study population. University education was associated with favorable outcome in CeAD-patients. The mechanism behind this association remains unclear.
Entities:
Keywords:
Cervical artery dissection; Ischemic stroke; Level of education; Outcome; Socioeconomic status; University education; Young adults
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