Pronostic intra hospitalier de l’accident vasculaire cérébral ischémique chez les sujets jeunes au Burkina Faso : une analyse comparative avec les sujets âgés

Pronostic intra hospitalier de l’accident vasculaire cérébral ischémique chez les sujets jeunes

Abstract

Abstract

Introduction : Acute ischemic stroke (AIS)  is one of the leading causes of death in low-income countries such as Burkina Faso. Its incidence is increasing in young subjects. However, there are no specific recommendations and guidelines for the management of stroke in young adults yet.  The aim of our study was to analyze the intra-hospital prognosis of ischemic stroke in young subjects (less than 45 years old) compared to elderly subjects in Burkina Faso.

Method : We conducted a retrospective cohort study, with a comparative aim, in three university hospitals in the city of Ouagadougou. Patients admitted between January 1, 2020 and December 31, 2022 and diagnosed with AIS were included in our study. We conducted a Cox regression to compare the survival of young and old subjects followed by a discontinuity regression for a sensitivity analysis of age-threshold outcomes.

Results : In total, we included 393 patients with AIS, including 262 elderly and 131 young. The most common risk factor was hypertension in young people (42.31%) and the elderly (64.50%). Intra-hospital mortality was 11.46% in young subjects and 12.26% in elderly subjects. Intrahospital survival of young subjects is not better than that of elderly subjects (adjusted hazard ratio (HRa): 0.58 (95%CI: 0.21-1.63)). On the other hand, the mRS score showed that younger subjects had better functional recovery than older subjects (p = 0.027).

Conclusion: The intra-hospital prognosis of AIS in young subjects is not better than that of elderly subjects. On the other hand, functional recovery is good in young subjects. Our result should draw the attention of hospital providers, hospital managers and the young subject to adapt more favorable behaviors.