Platform Presentation The Joint Annual Meeting of the Stroke Society of Australasia (SSA) and Smartstrokes 2023

An International Perspective of Incidence and Risk factors of Young Stroke: a Scoping Review (#14)

Dinah Amoah 1 , Matthew Schmidt 1 , Carey Mather 2 , Sarah Prior 3 , Manoja P. Herath 1 , Karen Borschmann 4 , Marika Demers 5 , Brodie M. Sakakibara 6 , Jade Cartwright 1 , Kofi Awuviry- Newton 7 , Barbara Wolfenden 8 , Christina Miteff 9 , Emelyn Jovic 1 , Marie-Louise Bird 1
  1. School of Health Sciences, University of Tasmania, Launceston, Tasmania, Australia
  2. Australian Institute of Health Service Management, University of Tasmania, Hobart, TAS
  3. Tasmanian School of Medicine, University of Tasmania, Burnie, Tasmania, Australia
  4. The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Heidelberg, Melbourne, Australia
  5. School of Rehabilitation, Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada
  6. Department of Occupational Science and Occupational Therapy, Faculty of Medicine, The University of British Columbia, Okanagan, British Columbia, Canada
  7. School of Allied Health, College of Sport, Health and Engineering, Victoria University, Victoria, Melbourne, Australia
  8. Wolfenden Healing Equine Assisted Therapy, Victoria, Melbourne, Australia
  9. John Hunter Children’s Hospital, Newcastle, New South Wales, Australia

Background: Stroke within younger age groups is increasing globally. While there is focus on research conducted on people under 65 years who have had a stroke, there is a paucity of data on the incidence and risk factors of stroke among younger people (≤ 30 years) who are sociodemographically unique.

Aims: To examine evidence on incidence and risk factors for perinatal, childhood and young adult stroke in different countries.

Methods: A systematic search was conducted on 23rd March 2022 and included articles published in the last ten years across Medline Ovid, Embase, PsycINFO and CINAHL databases.

Results: A total of 5750 articles were identified. After screening, 471 articles were included (224 cohort studies (47.6%), 164 case studies/case series (34.8%), 35 reviews, 30 case-control and 18 combination of designs. We had data from 50 different countries; 199 studies were from high-income countries, 3 were from low-income countries, and a further 185 did not state the country of research. Most (63.0%) of studies focused on risk factors, while incidence constituted 37.0%. Incidence data was reported heterogeneously across studies, leading to an inability to synthesise data. The three most frequently reported risk factors for perinatal stroke were infections, cardiac conditions, and intrapartum factors. Vasculopathies, infection and cardiac conditions were the most reported risk factors for paediatric stroke, while chronic conditions (e.g. diabetes), vasculopathies and cardiac conditions mostly accounted for stroke among young people.

Conclusion: This review has highlighted different risk factors for age cohorts of people under 30 years who have had a stroke. A large proportion of data from this cohort are reported in case studies, indicating that more robust methodological study designs are needed to improve the certainty of this data. A standardised reporting of age groupings of incidence data is imperative to enable the comparison of data from geographical locations.