Introduction: Recent research has highlighted an increased incidence of ischemic stroke (IS) in young adults, along with a higher percentage of vascular risk factors at younger ages. This study aimed to estimate the in-hospital incidence of IS and associated comorbidities by sex and age group in Spain. Methods: A retrospective analysis of the Spain Nationwide Inpatient Sample database from 2016 to 2019 was conducted, which included adult patients with IS. In-hospital incidence and mortality rates were estimated, and a descriptive analysis of the main comorbidities was performed, stratified by sex and age groups. Results: A total of 186,487 patients were included, with a median age of 77 (IQR 66–85) years and 53.3% were male. Of these, 9162 (5%) were aged between 18 and 50 years. The estimated incidence of IS in adults younger than 50 years ranged from 11.9 to 13.5 per 100,000 inhabitants during the study period, with a higher incidence in men. The overall in-hospital mortality was 12.6%. Young adults with IS had a higher prevalence of most vascular risk factors compared to the general Spanish population, with a specific distribution according to sex and age. Conclusions: This study provides estimates of the incidence of IS and the prevalence of vascular risk factors and comorbidities associated with IS in Spain, stratified by sex and age, using a national registry of hospital admissions. These findings should be considered in terms of both primary and secondary prevention strategies.
Objectives: Cardiac point-of-care ultrasound (cPOCUS) enables rapid bedside cardiac assessment and may facilitate early identification of potential cardiac sources of embolism in patients with acute ischemic stroke (AIS). This study aimed to evaluate whether neurologist-performed cPOCUS is associated with reduced hospital length of stay (LOS) in patients admitted to a Stroke Unit (SU). Methods: We conducted a retrospective observational study including consecutive patients with AIS admitted between 2020 and 2021 who required cardiac ultrasound for etiological evaluation. Patients underwent cPOCUS and/or transthoracic echocardiography (TTE) and were classified into two groups: those evaluated with cPOCUS (with or without TTE) and those evaluated exclusively with TTE (control group). The availability of cPOCUS depended on predefined weekly schedules rather than individual clinical decision-making, partially mitigating selection bias. The primary outcome was LOS. Multivariable linear regression analysis was performed to adjust for potential confounders. Results: Among 808 patients with AIS, 332 underwent cardiac ultrasonography during hospitalization: 219 in the cPOCUS group and 113 in the control group. Overall, 60.4% were male, the mean age was 68.4 years (SD 13.3), and the median National Institutes of Health Stroke Scale score at admission was 5 (IQR 9), with no significant differences between groups. Median LOS was shorter in the cPOCUS group than in the control group [7 days (IQR 4) vs. 8 days (IQR 5); p = 0.015]. After adjustment for confounders, cPOCUS evaluation remained independently associated with shorter LOS (β −1.49, standard error 0.73, 95% CI −2.93 to −0.05; p = 0.04). Conclusions: Neurologist-performed cPOCUS is independently associated with reduced LOS in patients with AIS admitted to an SU. These findings suggest that cPOCUS may facilitate more efficient in-hospital workflows and support its potential integration into routine stroke care pathways.
Objectives Cardiac point-of-care ultrasound (cPOCUS) enables rapid bedside cardiac assessment and may facilitate early identification of potential cardiac sources of embolism in patients with acute ischemic stroke (AIS). This study evaluated whether neurologist-performed cPOCUS is associated with a reduced hospital length of stay (LOS) in patients admitted to a Stroke Unit (SU). Methods We conducted a retrospective observational study including consecutive patients with AIS admitted between 2020 and 2021 who required cardiac ultrasound for etiological evaluation. Patients underwent cPOCUS and/or transthoracic echocardiography (TTE) and were classified into two groups: those evaluated with cPOCUS (with or without TTE) and those evaluated exclusively with TTE (control group). The availability of cPOCUS depended on predefined weekly schedules rather than individual clinical decision-making, partially mitigating selection bias. The primary outcome was LOS. Multivariable linear regression analyses were performed to adjust for potential confounders. Results Among 808 patients with AIS, 332 underwent cardiac ultrasonography during hospitalization: 219 in the cPOCUS group and 113 in the control group. Overall, 60.4% were male, the mean age was 68.4 years (SD 13.3), and the median National Institutes of Health Stroke Scale score at admission was 5 (IQR 9), with no significant differences between groups. Median LOS was shorter in the cPOCUS group than in the control group [7 days (IQR 4) vs. 8 days (IQR 5); p = 0.015]. After adjustment for confounders, cPOCUS evaluation remained independently associated with a shorter LOS (β −1.49, standard error 0.73). Conclusions Neurologist-performed cPOCUS is independently associated with reduced LOS in patients with AIS admitted to an SU. These findings suggest that cPOCUS may facilitate more efficient in-hospital workflows and support its potential integration into routine stroke care pathways.