Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular diseases (PEC2), University Hospital of Dijon, University of Burgundy, Dijon, France.
Neuroepidemiology. 2021;55(3):239-244. doi: 10.1159/000516054. Epub 2021 May 27.
Stroke is associated with major consequences in terms of socioeconomic impact and lost disability-adjusted life in young victims, thus justifying a careful surveillance of epidemiological trends. This study aimed to assess changes in the incidence of ischemic stroke in young adults over a long period.
All cases of first-ever ischemic stroke that occurred among adults aged 18-55 years were prospectively recorded using the population-based Dijon Stroke Registry, from 1985 to 2017. Sex-specific annual incidence rates were calculated and were presented according to 6 time periods. Incidence rate ratios (IRRs) were determined to assess sex differences in stroke incidence.
Over the whole study period, 4,451 patients suffered a first-ever ischemic stroke. Among these patients, 469 (10.5%) were young adults (median age: 46 years, IQR: 39-50; 53.9% men). Incidence rates rose from the study period 2003 to 2007 compared with previous periods and remained stable thereafter, both in men and women. Hence, incidence per 100,000 per year was globally 11.0 (95% CI: 9.4-12.7) before 2003 and 22.9 (20.3-25.6) thereafter. In individuals aged 18-45 years, incidence rates were 5.4 (4.3-6.9) overall, 4.1 (2.7-6.0) in men, and 6.7 (4.9-9.0) in women, before 2003. After 2003, incidence rates rose to 12.8 (10.7-15.1) overall, 12.0 (9.2-15.4) in men, and 13.6 (10.6-17.0) in women. In this age group, the men/women IRR was 0.78 (95% CI: 0.62-1.26, p = 0.08), although sex differences decreased over time (IRR = 0.62; 95% CI: 0.36-1.02, p = 0.046 before 2003, vs. IRR = 0.88; 95% CI: 0.62-1.26, p = 0.48 after 2003). In individuals aged 45-55 years, incidence rates before 2003 were 47 (37-61) in men and 25 (17-35) in women (IRR = 1.90; 95% CI: 1.24-2.97, p < 0.001), and they increased to 82 (67-100) in men and 46 (35-59) in women (IRR = 1.79; 95% CI: 1.29-2.49, p < 0.001) after 2003.
The incidence of ischemic stroke in young adults increased during the early 2000s and remained stable thereafter. These results highlight the priority need for dedicated prevention strategies for the young to reduce the burden of stroke.
中风会导致重大的社会经济影响和残疾调整生命年的丧失，因此需要对年轻患者的流行病学趋势进行仔细监测。本研究旨在评估年轻成年人中风发病率在很长一段时间内的变化。
使用基于人群的第戎中风登记处前瞻性记录了 1985 年至 2017 年期间发生的 18-55 岁成年人首次发生的缺血性中风的所有病例。根据 6 个时期计算了特定性别年度发病率，并进行了呈现。发病率比（IRR）用于评估中风发病率的性别差异。
在整个研究期间，4451 名患者发生了首次缺血性中风。其中 469 名（10.5%）为年轻成年人（中位数年龄：46 岁，IQR：39-50；53.9%为男性）。与之前的时期相比，2003 年至 2007 年期间的发病率上升，此后保持稳定，无论男女均如此。因此，全球每年每 100,000 人发病率为 11.0（95%CI：9.4-12.7），2003 年之前为 22.9（20.3-25.6）。在 18-45 岁的个体中，总体发病率为 5.4（4.3-6.9），男性为 4.1（2.7-6.0），女性为 6.7（4.9-9.0），2003 年之前。2003 年后，总体发病率上升至 12.8（10.7-15.1），男性为 12.0（9.2-15.4），女性为 13.6（10.6-17.0）。在该年龄组中，男性/女性 IRR 为 0.78（95%CI：0.62-1.26，p=0.08），尽管性别差异随着时间的推移而减小（IRR=0.62；95%CI：0.36-1.02，p=0.046，2003 年之前，vs.IRR=0.88；95%CI：0.62-1.26，p=0.48，2003 年之后）。在 45-55 岁的个体中，2003 年之前男性的发病率为 47（37-61），女性为 25（17-35）（IRR=1.90；95%CI：1.24-2.97，p<0.001），而在 2003 年之后，男性的发病率上升至 82（67-100），女性的发病率上升至 46（35-59）（IRR=1.79；95%CI：1.29-2.49，p<0.001）。
年轻成年人中风发病率在 21 世纪初上升，此后保持稳定。这些结果强调了制定专门的预防策略的必要性，以减少年轻人中风的负担。
