Increasing Incidence of Hospitalization for Stroke and Transient Ischemic Attack in Young Adults: A Registry-Based Study

Maiken Tibæk, Christian Dehlendorff, Henrik S Jørgensen, Hysse B Forchhammer, Søren P Johnsen, Lars P Kammersgaard, Maiken Tibæk, Christian Dehlendorff, Henrik S Jørgensen, Hysse B Forchhammer, Søren P Johnsen, Lars P Kammersgaard

Abstract

Background: Studies have reported increasing incidence of ischemic stroke in adults younger than 50 to 55 years. Information on temporal trends of other stroke subtypes and transient ischemic attack (TIA) is sparse. The aim of this study was to investigate temporal trends of the incidence of hospitalizations for TIA and stroke including sex- and subtype-specific trends in young adults aged 15 to 30 years.

Methods and results: From the Danish National Patient Register, we identified all cases of first-ever stroke and TIA (age 15-30 years) in Denmark, who were hospitalized during the study period of 1994 to 2012. Incidence rates and estimated annual percentage changes (EAPCs) were estimated by using Poisson regression. During the study period, 4156 cases of first-ever hospitalization for stroke/TIA were identified. The age-standardized incidence rates of hospitalizations for stroke increased significantly (EAPC 1.83% [95% CI 1.11-2.55%]) from 11.97/100 000 person-years (PY) in 1994 to 16.77/100 000 PY in 2012. TIA hospitalizations increased from 1.93/100 000 PY in 1994 to 5.81/100 000 PY in 2012 and after 2006 more markedly in men than in women (EAPC 16.61% [95% CI 10.45-23.12%]). The incidence of hospitalizations for ischemic stroke was markedly lower among men, but increased significantly from 2006 (EAPC 14.60% [95% CI 6.22-23.63%]). The incidences of hospitalizations for intracerebral hemorrhage and subarachnoid hemorrhage remained stable during the study period.

Conclusions: The incidence rates of first-time hospitalizations for ischemic stroke and TIA in young Danish adults have increased substantially since the mid 1990s. The increase was particularly prominent in the most recent years.

Keywords: epidemiology; incidence; sex‐specific; stroke in young adults; transient ischemic attack.

© 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

Figures

Figure 1
Figure 1
Age‐standardized incidence rates per 100 000 person‐years for hospitalizations for overall stroke (ie, all subtypes combined) and transient ischemic attack (TIA) separately. Points are the age‐standardized incidence rates, whereas the solid lines are the estimated trends of the standardized incidence rates and the dashed lines represent the corresponding 95% CIs.
Figure 2
Figure 2
Age‐standardized incidence rates per 100 000 person‐years for hospitalizations for subtypes of stroke: (A) ischemic, unspecified, and nonhemorrhagic stroke and (B) intracerebral hemorrhage (ICH) and subarachnoid hemorrhage (SAH), separately. Points are the age‐standardized incidence rates, whereas the solid lines are the estimated trends in the standardized incidence rates and the dashed lines represent the corresponding 95% CIs.
Figure 3
Figure 3
Age‐standardized incidence rates per 100 000 person‐years for men and women for hospitalizations for (A) ischemic stroke, (B) unspecified stroke, (C) nonhemorrhagic stroke, and (D) transient ischemic attack (TIA). Points are the age‐standardized incidence rates, whereas the solid lines are the estimated trends in the standardized incidence rates and the dashed lines represent the corresponding 95% CIs.

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