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March 31, 2023PLoS ONEOpen Access

Impact of sex in stroke in the young

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Key result

Female sex accounted for a higher proportion of strokes in the very young age group (16-35 years) compared to men (53.8% vs 46.2%), largely driven by sex-specific risk factors.

Why the study?

Do risk factors, etiology, stroke localization, severity, management, and outcome differ by sex in young patients (16-55 years) with acute ischemic stroke?

Population

689 patients aged 16-55 years with acute ischemic stroke consecutively included in the Bernese stroke…

Design

Cohort

Authors

ASAnina SchwarzwaldUFUrs FischerDSDavid Julian Seiffge

Discussion

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Overview

May support sex-specific risk assessment in very young women with stroke; leaves open whether findings alter management or outcomes.

Study Design

Type

Cohort (n=689)

Multicenter

No

Structured PICO

Do risk factors, etiology, stroke localization, severity, management, and outcome differ by sex in young patients (16-55 years) with acute ischemic stroke?

P
Population
689 young adults aged 16 to 55 years with acute ischemic stroke or transient ischemic attack, prospectively followed for 3 months to assess sex differences in stroke characteristics.
O
Outcome
Sex differences in risk factors, etiology, stroke localization, severity on admission, management and outcome

Main Result

Absolute Event Rate: 53.8% vs 46.2%

p-value: p=<0.001

Sex-specific risk factors in women contribute significantly to the higher incidence of stroke in very young women (16-35 years), while traditional modifiable risk factors do not differ by sex in young stroke patients.

Limitations

  • Not population-based, risking selection bias from tertiary care setting
  • Ethnic bias with >95% Caucasian population
  • Did not consider socioeconomic factors or quality of life
  • No adjustment for multiple testing
  • Lack of a control group of young adults without stroke

Cite This Study

Schwarzwald et al. (2023) conducted a cohort in Acute ischemic stroke in young adults (n=689). Female sex vs. Male sex was evaluated on Proportion of stroke cases in the very young age group (16-35 years) (p=<0.001). Female sex accounted for a higher proportion of strokes in the very young age group (16-35 years) compared to men (53.8% vs 46.2%), largely driven by sex-specific risk factors.

synapsesocial.com/papers/6ab78d1caed41efa91939edfhttps://doi.org/10.1371/journal.pone.0274722
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Sex differences in etiologies, risk factors, and outcomes among young adult patients with acute ischemic stroke2025 · 2 citations
  2. 2Sex Differences in Ischemic Stroke Within the Younger Age Group: A Register-Based Study2022 · 8 citations
  3. 3Sex-Specific Trends and Differences in Clinical Outcomes Among Young Patients With Ischemic Stroke2025
  4. 4Abstract WP113: Stroke in the Young: Sex Differences in Risk Factors, Etiologies, Acute Treatments, and Outcomes in a Nationwide Analysis2026
  5. 5Sex Differences in Young Adult Stroke Severity Using Linked Colorado—All Payer's Claims Database and the Get With The Guidelines‐Stroke Registry2026 · 1 citations