Sudden unexpected death caused by stroke: A nationwide study among children and young adults in Denmark

Frederik Nybye Ågesen; Bjarke Risgaard; Sára Zachariasardóttir; Reza Jabbari; Thomas Hadberg Lynge; Ole Ingemann-Hansen; Gyda Lolk Ottesen; Jørgen Lange Thomsen; Stig Haunsø; Derk Wolfgang Krieger; Bo Gregers Winkel; Jacob Tfelt-Hansen

doi:10.1177/1747493017724625

Sudden unexpected death caused by stroke: A nationwide study among children and young adults in Denmark

Frederik Nybye Ågesen, Bjarke Risgaard, Sára Zachariasardóttir, Reza Jabbari, Thomas Hadberg Lynge, Ole Ingemann-Hansen, Gyda Lolk Ottesen, Jørgen Lange Thomsen, Stig Haunsø, Derk Wolfgang Krieger, Bo Gregers Winkel, Jacob Tfelt-Hansen

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Abstract

Background Stroke is the fifth leading cause of death in young individuals globally. Data on the burden of sudden death by stroke are sparse in the young. Aims The aim of this study was to report mortality rates, cause of death, stroke subtype, and symptoms in children and young adults who suffered sudden death by stroke. Methods We conducted a retrospective, nationwide study including all deaths within Danish borders between 2000-2009 and 2007-2009 in persons aged 1-35 years and 36-49 years, respectively. Two physicians identified all sudden death cases through review of all death certificates. All available autopsy reports and records from hospitals and general practitioners were retrieved and a neurologist identified all sudden death by stroke cases. Results Of the 14,567 deaths in the 10-year period, there were 1,698 sudden death cases, of which 52 (3%) were sudden death by stroke. There was a male predominance (56%) and the median age was 33 years. The incidence of sudden death by stroke in individuals aged 1-49 years was 0.19 deaths per 100,000 person-years. Stroke was hemorrhagic in 94% of cases, whereof subarachnoid hemorrhage was the cause of death in 63% of cases. Seventeen (33%) cases contacted the healthcare system because of neurological symptoms, whereof one was suspected of having a stroke (6%). Conclusions Sudden death by stroke in children and young adults occurs primarily due to hemorrhagic stroke. We report a high frequency of neurological symptoms prior to sudden death by stroke. Increased awareness among healthcare professionals towards stroke symptoms in children and young adults may lead to earlier detection of stroke, and thereby potentially lowering the incidence of sudden death by stroke.

Original language	English
Journal	International Journal of Stroke
Volume	13
Issue number	3
Pages (from-to)	285–291
ISSN	1747-4930
DOIs	https://doi.org/10.1177/1747493017724625
Publication status	Published - 1 Apr 2018

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Journal Article

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10.1177/1747493017724625Licence: CC BY

Research Sudden unexpected death caused by strokeFinal published version, 2.21 MBLicence: CC BY

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Ågesen, F. N., Risgaard, B., Zachariasardóttir, S., Jabbari, R., Lynge, T. H., Ingemann-Hansen, O., Ottesen, G. L., Thomsen, J. L., Haunsø, S., Krieger, D. W., Winkel, B. G., & Tfelt-Hansen, J. (2018). Sudden unexpected death caused by stroke: A nationwide study among children and young adults in Denmark. International Journal of Stroke, 13(3), 285–291. https://doi.org/10.1177/1747493017724625

Ågesen, FN, Risgaard, B, Zachariasardóttir, S, Jabbari, R, Lynge, TH, Ingemann-Hansen, O, Ottesen, GL, Thomsen, JL, Haunsø, S, Krieger, DW, Winkel, BG & Tfelt-Hansen, J 2018, 'Sudden unexpected death caused by stroke: A nationwide study among children and young adults in Denmark', International Journal of Stroke, vol. 13, no. 3, pp. 285–291. https://doi.org/10.1177/1747493017724625

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title = "Sudden unexpected death caused by stroke: A nationwide study among children and young adults in Denmark",

abstract = "Background Stroke is the fifth leading cause of death in young individuals globally. Data on the burden of sudden death by stroke are sparse in the young. Aims The aim of this study was to report mortality rates, cause of death, stroke subtype, and symptoms in children and young adults who suffered sudden death by stroke. Methods We conducted a retrospective, nationwide study including all deaths within Danish borders between 2000-2009 and 2007-2009 in persons aged 1-35 years and 36-49 years, respectively. Two physicians identified all sudden death cases through review of all death certificates. All available autopsy reports and records from hospitals and general practitioners were retrieved and a neurologist identified all sudden death by stroke cases. Results Of the 14,567 deaths in the 10-year period, there were 1,698 sudden death cases, of which 52 (3%) were sudden death by stroke. There was a male predominance (56%) and the median age was 33 years. The incidence of sudden death by stroke in individuals aged 1-49 years was 0.19 deaths per 100,000 person-years. Stroke was hemorrhagic in 94% of cases, whereof subarachnoid hemorrhage was the cause of death in 63% of cases. Seventeen (33%) cases contacted the healthcare system because of neurological symptoms, whereof one was suspected of having a stroke (6%). Conclusions Sudden death by stroke in children and young adults occurs primarily due to hemorrhagic stroke. We report a high frequency of neurological symptoms prior to sudden death by stroke. Increased awareness among healthcare professionals towards stroke symptoms in children and young adults may lead to earlier detection of stroke, and thereby potentially lowering the incidence of sudden death by stroke.",

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author = "{\AA}gesen, {Frederik Nybye} and Bjarke Risgaard and S{\'a}ra Zachariasard{\'o}ttir and Reza Jabbari and Lynge, {Thomas Hadberg} and Ole Ingemann-Hansen and Ottesen, {Gyda Lolk} and Thomsen, {J{\o}rgen Lange} and Stig Hauns{\o} and Krieger, {Derk Wolfgang} and Winkel, {Bo Gregers} and Jacob Tfelt-Hansen",

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T1 - Sudden unexpected death caused by stroke

T2 - A nationwide study among children and young adults in Denmark

AU - Ågesen, Frederik Nybye

AU - Risgaard, Bjarke

AU - Zachariasardóttir, Sára

AU - Jabbari, Reza

AU - Lynge, Thomas Hadberg

AU - Ingemann-Hansen, Ole

AU - Ottesen, Gyda Lolk

AU - Thomsen, Jørgen Lange

AU - Haunsø, Stig

AU - Krieger, Derk Wolfgang

AU - Winkel, Bo Gregers

AU - Tfelt-Hansen, Jacob

PY - 2018/4/1

Y1 - 2018/4/1

N2 - Background Stroke is the fifth leading cause of death in young individuals globally. Data on the burden of sudden death by stroke are sparse in the young. Aims The aim of this study was to report mortality rates, cause of death, stroke subtype, and symptoms in children and young adults who suffered sudden death by stroke. Methods We conducted a retrospective, nationwide study including all deaths within Danish borders between 2000-2009 and 2007-2009 in persons aged 1-35 years and 36-49 years, respectively. Two physicians identified all sudden death cases through review of all death certificates. All available autopsy reports and records from hospitals and general practitioners were retrieved and a neurologist identified all sudden death by stroke cases. Results Of the 14,567 deaths in the 10-year period, there were 1,698 sudden death cases, of which 52 (3%) were sudden death by stroke. There was a male predominance (56%) and the median age was 33 years. The incidence of sudden death by stroke in individuals aged 1-49 years was 0.19 deaths per 100,000 person-years. Stroke was hemorrhagic in 94% of cases, whereof subarachnoid hemorrhage was the cause of death in 63% of cases. Seventeen (33%) cases contacted the healthcare system because of neurological symptoms, whereof one was suspected of having a stroke (6%). Conclusions Sudden death by stroke in children and young adults occurs primarily due to hemorrhagic stroke. We report a high frequency of neurological symptoms prior to sudden death by stroke. Increased awareness among healthcare professionals towards stroke symptoms in children and young adults may lead to earlier detection of stroke, and thereby potentially lowering the incidence of sudden death by stroke.

AB - Background Stroke is the fifth leading cause of death in young individuals globally. Data on the burden of sudden death by stroke are sparse in the young. Aims The aim of this study was to report mortality rates, cause of death, stroke subtype, and symptoms in children and young adults who suffered sudden death by stroke. Methods We conducted a retrospective, nationwide study including all deaths within Danish borders between 2000-2009 and 2007-2009 in persons aged 1-35 years and 36-49 years, respectively. Two physicians identified all sudden death cases through review of all death certificates. All available autopsy reports and records from hospitals and general practitioners were retrieved and a neurologist identified all sudden death by stroke cases. Results Of the 14,567 deaths in the 10-year period, there were 1,698 sudden death cases, of which 52 (3%) were sudden death by stroke. There was a male predominance (56%) and the median age was 33 years. The incidence of sudden death by stroke in individuals aged 1-49 years was 0.19 deaths per 100,000 person-years. Stroke was hemorrhagic in 94% of cases, whereof subarachnoid hemorrhage was the cause of death in 63% of cases. Seventeen (33%) cases contacted the healthcare system because of neurological symptoms, whereof one was suspected of having a stroke (6%). Conclusions Sudden death by stroke in children and young adults occurs primarily due to hemorrhagic stroke. We report a high frequency of neurological symptoms prior to sudden death by stroke. Increased awareness among healthcare professionals towards stroke symptoms in children and young adults may lead to earlier detection of stroke, and thereby potentially lowering the incidence of sudden death by stroke.

KW - Journal Article

U2 - 10.1177/1747493017724625

DO - 10.1177/1747493017724625

M3 - Journal article

C2 - 28762897

SN - 1747-4930

VL - 13

SP - 285

EP - 291

JO - International Journal of Stroke

JF - International Journal of Stroke

IS - 3

ER -

Sudden unexpected death caused by stroke: A nationwide study among children and young adults in Denmark

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