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New study sheds light on the long-term health risks of young stroke patients. How should you respond?

August 13, 2019

    Since Luke Perry's premature passing due to stroke, public awareness surrounding the disease has skyrocketed—and for good reason. Until 2008, stroke was the third-leading cause of death, behind heart disease and cancer.[1] Since then, awareness efforts such as FAST and Time is Brain, in combination with advancements in treatment and diagnosis, have improved stroke mortality and incidence rates.[2] And with the majority of strokes occurring in Americans aged 65 and older, it's no surprise that these efforts have focused on our older populations.[3]

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    However, research published in the Journal of the American Heart Association is one of a number of recent studies focused on younger stroke patients, giving reason for organizations to rethink both their stroke prevention and management strategies.

    Study findings

    For the retrospective study, researchers compared the rate of long-term adverse health outcomes between stable stroke patients and matched controls. To investigate the role of age in stroke outcomes, researchers created two matched groups: a young cohort, aged 44 and below, and an older cohort, aged 45 and above. Each group was paired with a control cohort matched across a number of markers such as age, income level, and area of residence.

    As expected, the study found that both the young and older stroke/transient ischemic attack (TIA) groups had a higher long-term risk of adverse health outcomes compared to their matched controls. However, more surprisingly, the younger stroke patients were far more likely to experience long-term risk against their control group compared to the higher long-term risk experienced by the older cohort - even after adjustment for patient history of vascular comorbidities.

    Implications for providers

    The study findings present health care leaders with two challenges:

    1. Stroke prevention efforts need to go beyond the retirement village

      Regardless of the patient's age, tracking modifiable stroke risk factors, such as hypertension and smoking status, is paramount for prevention. This is especially true for those populations with higher risk, such as those with a family history of stroke.

      Outreach strategy should be focused on the population's specific needs. For example, organizations may want to survey younger patients on awareness surrounding stroke risk factors and symptoms as part of their annual wellness visit. From there, launch efforts in settings such as universities and the workplace.

    2. Make long-term care management a breeze, not a burden

      With one-in-four stroke survivors experiencing a second stroke at some point in their lives, organizations need to manage the full spectrum of stroke patient needs.[4] Yet young stroke patients experience a unique set of challenges when it comes to fully engaging with their care recovery, such as the pressure to return to work or support a family.

      Organizations need to make it effortless for these patients to keep in contact with their health care team, even in the months and years after discharge. Establishing a dedicated stroke clinic or assigning a care navigator can reduce the risk that patients fall through the cracks of long-term care management.

    [1] Lackland, D. T., et. al.,2014. Factors influencing the decline in stroke mortality: a statement from the American Heart Association/American Stroke Association. Stroke, 45(1), 315–353.

    [2] Koton S., Rexrode K. M., 2017. Trends in stroke incidence in the United States. Will women overtake men?. Neurology, 89(10), 982-983.

    [3] Stroke Statistics. (Reviewed 2017, September). Retrieved from https://www.cdc.gov/stroke/facts.htm.

    [4] Stroke Risk Factors Not Within Your Control. (Reviewed 2018, October). Retrieved from https://www.strokeassociation.org/en/about-stroke/stroke-risk-factors/stroke-risk-factors-not-within-your-control.


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