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SHR Neuro Cancer Cardio Lipid Metab Microb
Pinter, D; Broman, J; Leitner, M; von, Sarnowski, B; Elmegiri, M; Gattringer, T; Haidegger, M; Kneihsl, M; Malinowski, R; Martola, J; Ropele, S; Schminke, U; Tatlisumak, T; Enzinger, C; Putaala, J; Aarnio, K; Fandler-Höfler, S.
Long-term outcome of young patients after ischemic stroke or transient ischemic attack: Insights from a multicenter study.
Int J Stroke. 2025; 17474930251359422
Doi: 10.1177/17474930251359422
Web of Science
PubMed
FullText
FullText_MUG
- Leading authors Med Uni Graz
- Fandler-Höfler Simon
- Pinter Daniela Theresia
- Co-authors Med Uni Graz
- Enzinger Christian
- Gattringer Thomas
- Haidegger Melanie
- Kneihsl Markus
- Leitner Manuel
- Ropele Stefan
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- Abstract:
- BACKGROUND: The long-term non-motor outcome of young adults with ischemic stroke (IS) or transient ischemic attack (TIA) is poorly understood. AIMS: Therefore, in this observational cohort study, we explored the prevalence of impairment and factors influencing clinical and neuropsychological outcomes and return-to-work a decade post-stroke. METHODS: After a median follow-up duration of 10.4 years, 163 patients (median age at index event: 46.0 years, 44.8% female, 121 IS and 42 TIA) of the "Stroke in Young Fabry Patients study" attended an in-person follow-up in three European centers. We assessed clinical, neuropsychological, and return-to-work data. RESULTS: A decade post-stroke, most patients (74.8%) showed excellent outcome, scoring 0-1 on the modified Rankin Scale (mRS) and 68.0% had returned to work. However, at follow-up, 27.2% of patients showed cognitive impairment and 27.6% suffered from fatigue. Anxiety and depression were reported by 38.0% and 18.5%, respectively. Even among patients with excellent functional outcome (mRS 0-1), 24.6% showed cognitive problems, 37.7% suffered from anxiety, 22.1% from fatigue, and 12.4% from depression. Female patients had higher rates of anxiety (52.1% vs. 26.7%), fatigue (37.0% vs. 20.0%), and depression (27.4% vs. 11.2%), compared to male patients.In linear regression, female sex was associated with a higher likelihood for anxiety (odds ratio (OR = 2.89, 95% confidence interval (CI) = 0.62-5.16), fatigue (OR = 3.23, CI = 1.52-4.93), and depression (OR = 2.86, CI = 1.12-4.59). Hypertension at follow-up (52.1%) was associated with worse functional outcome (OR = 3.03, CI = 1.32-6.95), while patients smoking at follow-up (20.2%) had higher rates of anxiety (OR = 4.09, CI = 1.21-6.97) and depression (OR = 3.40, CI = 0.87-5.21). CONCLUSIONS: Despite excellent functional outcome, many young stroke patients experience neuropsychological impairment, highlighting the need for targeted screening and treatment. Particularly young women are at higher risk for post-stroke depression, anxiety, and fatigue. Hypertension and smoking were modifiable risk factors contributing to worse outcomes in this young stroke cohort.
- Find related publications in this database (Keywords)
- Young stroke
- long-term follow-up
- cognition
- fatigue
- anxiety
- depression
- modifiable risk factors