Introduction: Young adults with ischemic stroke may present late to medical care, and the reasons for these delays are unknown.
Hypothesis: We hypothesized that some medical conditions, social factors, and low stroke severity would be associated with delayed presentations to medical attention.
Methods: We performed a retrospective cohort study of adults ages 18 to 50 admitted to a single academic medical center between 2007-2012.
Results: 61% of 141 young adults with ischemic stroke presented more than 4.5 hours after stroke onset. Diabetes was associated with delays in presentation (p = 0.03), whereas systemic cancer was associated with early presentations (p = 0.03). Individuals who were single were more likely to present late than those who were married or living with a partner (p = 0.005). Age (dichotomized by 18-35 and 36-50), race, employment or schooling status, home medications, other medical conditions (including common stroke mimics such as migraine, seizure, and psychiatric disease), and stroke subtype were not determinants of delay in presentation, although there was a non-significant trend towards delayed presentations in women (p = 0.08) and with low stroke severity (dichotomized by NIHSS ≤ 5 and NIHSS > 5, p = 0.06).
Conclusions: A majority of young adults with ischemic stroke presented outside the time window for intravenous fibrinolysis. Diabetes and single status were associated with a greater risk of delayed presentation.