Abstract 215: Increasing Risk Of Hospitalizations For Young-onset Stroke With Improving Survival Odds – A Nationwide Analysis Of Two Cohorts A Decade Apart In The United States

Background: The scarcity of large-scale trends data on young-onset stroke prompted us to explore the difference in stroke hospitalization and inpatient outcomes among young adults from two nationwide cohorts 10 years apart.

Methods: The National Inpatient Sample (2007 & 2017) was utilized to identify stroke admissions among young adults(18-44 years). We compared demographics, comorbidities, inpatient outcomes and gender/racial disparities in frequency of stroke admissions and mortality between the two cohorts 10-years apart.

Results: There was an increase in stroke admissions of young adults in 2017 (0.7%, n=58965/8,568,874, aOR: 1.48, 95%CI:1.46-1.5, p<0.001) compared to 2007 (0.4%, n=41379/10,330,126) [Table 1]. The 2017 cohort often included female (49.0% vs 48.4%), non-elective admissions (94.0% vs 90.9%), Medicaid beneficiary (35% vs 23.4%) and urban teaching hospitalizations (81% vs 61.6%)(p<0.05) vs. the 2007 cohort. Cardiovascular comorbidities like hypertension, hyperlipidemia, obesity, peripheral vascular disorders, congestive heart failure and atrial fibrillation/flutter were significantly more prevalent in the 2017 cohort vs. 2007. Reassuringly, with advanced medical and interventional therapeutics in the last decade, the odds of in-hospital mortality decreased in 2017 (aOR 0.84, 95%CI: 0.79-0.89) vs. 2007. Females, Caucasians and Hispanics witnessed a higher relative increase in stroke hospitalizations in 2017. In addition, compared to 2007, a significant decline in mortality was noticed among both sexes but Hispanics and Asians did not show an improvement in survival odds in2017 vs 2007.

Conclusion: Comparison of two young stroke cohorts a decade apart shows an alarming rise in stroke hospitalizations (nearly 50% higher) with cardiovascular disease risk factors, particularly in the female gender, with declining in-hospital mortality. Persistent racial disparities warrant an inclusive approach in preventive care.