Donna Armaignac, CCNS, CCRN-K, PhD
Director Center Advanced Analytics; Director Best Practice Tele Critical Care
Baptist Health South Florida
Pompano Beach, Florida, United States
Disclosure information not submitted.
Venkataraghavan Ramamoorthy
Baptist Health South Florida
Coral Gables, Florida
Disclosure information not submitted.
Munir B. Rubens, PhD
Biostatistician
Baptist Health South Florida, United States
Disclosure information not submitted.
Title: Clinical Characteristics and Hospital Outcomes among Young Acute Ischemic Stroke Patients
Introduction: Acute ischemic stroke (AIS) among young patients is increasing in the US. This study sought to describe the risk factors, clinical characteristics, and hospital outcomes of young AIS patients.
Methods: Retrospective analysis of EHR data from a Regional Comprehensive Stroke Center of Excellence. The data was collected from patients admitted to ICU between October 2016 and February 2021 and included AIS patients between 18 and 45 years of age. Correlation and regression analysis were performed in order to understand the relation between risk predictors such as Acute Physiology and Chronic Health Evaluation (APACHE) IV score, Acute Physiology Score (APS), National Institute of Health Stroke Score (NIHSS), and Intensive Care after Thrombolytic (ICAT) and hospital outcomes.
Results: There were 217 young AIS patients and 50.2% were males. More than half of the patients were white Hispanic (53.5%), followed by African American (24.4%), and whites (13.4%). Nearly 7.8% patients received intravenous thrombolysis, 1.8% endovascular mechanical reperfusion therapy, and 5.5% both treatments. Nearly 15.7% were smokers, 46.1% were hypertensive, 30.9% were dyslipidemic, 18.4% had previous stoke, 48.8% were obese or overweight, 17.5% were diabetic, 2.3% had carotid stenosis, 5.5% had CAD, and 1.4% had dysrhythmia. The mean (standard deviation) of APACHE, APS, NIHSS and ICAT scores were 5.0 (3.8), 33.8 (17.5), 5.5 (8.5), and 1.5 (1.5) respectively. Severity adjusted mean (SD) length of stay in hospital and ICU were 1.2 (0.9) and 1.2 (1.2) days, respectively. Severity adjusted ventilator days were 1.7 (2.1) days. Mean severity (SD) adjusted ICU and in-hospital mortality rates were 0.05 (0.54) and 0.60 (2.8) respectively. Correlation and regression analysis showed no association between risk predictors and adverse hospital outcome variables.
Conclusion: Risk predictors did not show association with adverse hospital outcomes among young AIS patients. Significant number of young AIS patients had chronic conditions, which could have increased their risk for stroke. Strategies to decrease these risk factors to lower stroke rates should be prioritized among all these patients, independent of their risk scores.