Risk Factors, Incidence, and Outcome of Stroke: A Retrospective Cross-Sectional Hospital-Based Study Comparing Young Adults and Elderly.

A noticeable increase of up to 40% in the incidence of stroke among young population over the past decade has been noted. This study aimed to investigate the incidence, risk factors, and outcomes of stroke and its subtypes in young adults compared to older population. A retrospective study of patients which included patients with confirmed diagnosis of stroke based on the International Classification of Diseases 10th Revision (ICD-10) classification between the years 2018 and 2020 was conducted. The results indicated that patients less than 45 years of age had a higher incidence of hemorrhagic stroke as compared to the other age groups (p=0.011). Hypertension leading to hemorrhagic stroke was higher in patients less than 45 years of age as compared to other groups (18 years {19.4%} versus 33 years {7.5%}, p=0.001). Hypertension was noted to be the leading risk factor for stroke among the younger population.

Stroke services in MENA: What is there and what is needed.

OBJECTIVES: Stroke represents a health care challenge to most parts of the world including the Middle East and North Africa (MENA) region. The MENA represents 6% of the world population with an age-standardized stroke rate of 87.7 (78.2-97.6) per 100,000 population. This number is subject to increase given that the cause of morbidity has recently shifted from infectious diseases to non-communicable diseases. Thus, in the coming years, treatment of stroke will pose a major burden on MENA countries which mostly lie in the low to middle income economies. Accordingly, we need to study the state of MENA stroke services in order to recognize and further inform policy makers about any gaps that need to be bridged in this domain. METHODS AND RESULTS: Stroke specialists representing 16 countries filled an online survey that included: screening for risk factors, acute management, diagnostics, medications, post-discharge services, and stroke registries. Results showed that 11 countries screen for risk factors, 16 have neuroimaging studies, 15 provide intravenous thrombolysis (IVT), 13 mechanical thrombectomy (MT) while medications for secondary prevention are available in all countries. However, stroke units are not equally available and even absent in 4 countries, and despite the availability of IVT yet, the rate of administration is still low in 6 countries (<5%), and ranges from 5-20% in 7 countries. Stroke registries and training still need to be implemented in most countries. CONCLUSION: Although imaging, revascularization therapies and medications for secondary prevention are available in most MENA countries, yet the rate of revascularization is low, so is the number of stroke units insufficient in some countries. Additionally, registries and structured training are still defective. Further field studies are required for more accurate determination of the status of stroke services in the MENA region.