J Clin Neurol.  2020 Oct;16(4):605-611. 10.3988/jcn.2020.16.4.605.

Causes, Risk Factors, and Clinical Outcomes of Stroke in Korean Young Adults: Systemic Lupus Erythematosus is Associated with Unfavorable Outcomes

Affiliations
  • 1Department of Neurology, Hanyang University College of Medicine, Seoul, Korea
  • 2Department of Neurology, Hallym University Sacred Heart Hospital, Chuncheon, Korea
  • 3Department of Neurology, Seoul National University Hospital, Seoul, Korea
  • 4Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
  • 5Department of Neurology, Seoul National University College of Medicine, Seoul Metropolitan GovernmentSeoul National University Boramae Medical Center, Seoul, Korea
  • 6Department of Neurology and Cerebrovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea
  • 7Department of Neurology, Chung-Ang University Hospital, Seoul, Korea
  • 8Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
  • 9Department of Neurology, Kyung Hee University College of Medicine, Seoul, Korea

Abstract

Background
and Purpose: The incidence of ischemic stroke (IS) in young adults is increasing, and the associated large socioeconomic impact makes understanding IS in young adults important. We investigated the causes of and risk factors for IS in young adults, and their impact on outcomes.
Methods
The Stroke in Korean Young Adults (SKY) study is a standardized multicenter prospective study involving eight medical centers of the Republic of Korea. First-ever IS patients aged 18 years to 44 years were prospectively included in this study within 7 days of stroke onset. Their outcomes at 3 months were analyzed.
Results
This study enrolled 270 patients from April 2014 to December 2018, most (67.8%) of whom were male. About 41.5% of the patients had one or more vascular risk factors from among hypertension, diabetes mellitus, and dyslipidemia. However, only half of them had received regular treatment. Arterial dissection was more common in males, and systemic lupus erythematosus (SLE) and Moyamoya disease were more common in females. The outcome was favorable (modified Rankin Scale score of 0 or 1) in 81.9% of the patients at 3 months after stroke onset. More severe initial symptoms, higher initial glucose level, and SLE as a comorbidity were associated with unfavorable outcomes.
Conclusions
Young adult IS patients in Korea exhibit low awareness and poor management of their risk factors. Although the short-term outcome was relatively favorable in those patients, having SLE was associated with unfavorable outcomes. More attention needs to be paid for improving awareness and controlling risk factors in this population.

Keyword

ischemic stroke; young adults; outcome; systemic lupus erythematosus
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