(HealthDay News) – For adults aged 18–50 years with acute stroke, 20-year mortality is higher than expected, according to a study published in the March 20 issue of the Journal of the American Medical Association.

Loes C.A. Rutten-Jacobs, from Radboud University Nijmegen Medical Center in the Netherlands, and colleagues conducted a prospective cohort study of prognosis in 959 consecutive patients, aged 18–50 years, with first-ever transient ischemic attack, ischemic stroke, or hemorrhagic stroke. Participants were followed for a mean of 11.1 years, during which time observed mortality was compared with expected mortality, derived from mortality rates for the general population.

The researchers found that 20% of patients had died at the end of follow-up. Among 30-day survivors, the observed 20-year mortality exceeded expected mortality in the general population for each stroke type (observed vs. expected standardized mortality ratios: 2.6 for transient ischemic attack; 3.9 for ischemic stroke; 3.9 for intracerebral hemorrhage). Among 30-day survivors, the cumulative 20-year mortality was higher in men than women (33.7% vs.19.8%), with standardized mortality ratios of 4.3 and 3.6, respectively. Observed mortality exceeded expected mortality for all etiologic subtypes of ischemic stroke.

“To conclude, among adults aged 18–50 years, 20-year mortality following first acute stroke was relatively high compared with expected mortality,” the authors write.

One author disclosed financial ties to Boehringer Ingelheim.

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