Abstract A010: Temporal Trends in the Incidence and Case Fatality Rates of Stroke in the Young: A Population-Based Study

Introduction: While declining overall, stroke-related mortality is rising in the young. We sought to better characterize this trend by examining stroke incidence, case fatality rates, and risk factors among young individuals in a large population-based study of stroke from 1993 to 2020. Methods: In a stroke surveillance study covering a 5-county region of southern Ohio and northern Kentucky, hospital cases of stroke were ascertained and adjudicated by trained study physicians during six one-year periods (07/1993-06/1994, 1999, 2005, 2010, 2015, and 2020). Young individuals were defined as ages 20 to 54 years old. Incidence rates were generated using United States Census data standardized to the 2010 population, and 95% confidence intervals were calculated assuming a Poisson distribution. Temporal trends were examined using linear regression. With data from the national death index, 30-day case fatality rates were generated. Trends over time were evaluated with logistic regression, and adjusted for age, race, and sex. Results: There were 2,076 first-ever strokes among young individuals across all study periods. Young individuals with stroke were more likely to have documented hypertension, diabetes, atrial fibrillation, illicit drug use, and marijuana use in recent years (P