Demographics, risk factor profiles and etiologies in young ischemic and hemorrhagic stroke - the United Kingdom Young Stroke Study (UKYSS).

INTRODUCTION: Young stroke incidence is increasing worldwide. Risk factors and stroke etiologies vary between centers and regions. We present baseline characteristics from the United Kingdom Young Stroke Study (UKYSS). METHODS: UKYSS (ISRCTN 11029266), an ambispective observational study, examined young adults suffering first ever stroke in eight UK centers. Data on demographics, risk factors, clinical presentation, clinical investigations, imaging and diagnosis was collected. Whole cohort analysis was performed with sub-group analysis by sex, age, ethnicity and stroke type. Chi squared or Fisher exact test compared categorical variables between groups and Student's t-test or Mann-Whitney U test compared means between groups. RESULTS: Of 1765 strokes with mean age 41.6 years (SD 7.1), 61.7% (1089) were male and 82.4% (1454) white. Males had higher hypertension, hyperlipidemia, excess alcohol use and females higher migraine and active malignancy. 45-49-year-olds had higher smoking, hypertension, diabetes, hyperlipidemia, excess alcohol use, coronary artery disease, and atrial fibrillation and 18-44 year olds higher recreational drug use, combined oral conceptive pill use and active malignancy. Whites had higher smoking, excess alcohol use, recreational drug use and migraine whilst non-whites had higher hypertension, diabetes and hyperlipidemia. 38.1% (542) of ischemic strokes were hypertensive and 50.8% (723) cryptogenic. 13.4% (191) received intravenous thrombolysis, 5% (71) mechanical thrombectomy. 15.3% (52) of hemorrhagic strokes underwent neurosurgery, with hypertension the commonest risk factor (56.6%; 192) and etiology (49.6%; 168). CONCLUSION: UKYSS is a large multicentre cohort highlighting the heterogeneous demographic characteristics, vascular risk factors and etiologies of young stroke in the UK.