Trends in stroke hospitalizations and associated risk factors among children and young adults, 1995-2008

Abstract

Objective: The aim of this study was to determine acute stroke hospitalization rates for children and young adults and the prevalence of stroke risk factors among children and young adults hospitalized for acute stroke.

Methods: The study population consisted of 1995-2008 hospitalizations from the Nationwide Inpatient Sample of the Healthcare Cost and Utilization Project. Subarachnoid hemorrhage, intracerebral hemorrhage, and ischemic stroke hospitalizations were identified by the primary International Classification of Diseases, 9th ed, Clinical Modification (ICD-9-CM) code. Seven consecutive 2-year time intervals were selected. Three age groups were utilized: 5 to 14 years, 15 to 34 years, and 35 to 44 years. Stroke risk factors and comorbidities among those hospitalized with acute stroke were identified by secondary ICD-9-CM codes.

Results: During the period of study, the prevalence of hospitalizations of acute ischemic stroke increased among all age and gender groups except females aged 5 to 14 years. Females aged 15 to 34 years and males and females aged 35 to 44 years showed a decrease in the prevalence of hospitalizations for subarachnoid hemorrhage, whereas females aged 5 to 14 years showed increases for subarachnoid hemorrhage. Hypertension, diabetes, obesity, lipid disorders, and tobacco use were among the most common coexisting conditions, and their prevalence increased from 1995 to 2008 among adolescents and young adults (aged 15-44 years) hospitalized with acute ischemic stroke.

Interpretation: Increases in the prevalence of ischemic stroke hospitalizations and coexisting traditional stroke risk factors and health risk behaviors were identified among acute ischemic stroke hospitalizations in young adults. Our results from national surveillance data accentuate the need for public health initiatives to reduce risk factors for stroke among adolescents and young adults.