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    Comparative Study of Ischemic Stroke in Patients Aged Above and Below 50 Years Admitted to a Tertiary Care Hospital in Ulaanbaatar
    (Mongolian National University of Medical Sciences, 2016-11-25) ;
    Tsagaankhuu Guntev
    ;
    ; ;
    Objectives: The aim of this study was to compare characteristics of ischemic stroke between young (20-49 years) and old (50-89 years) patients undergoing investigations and treatment according to one common protocol in a tertiary hospital. Methods: This hospital-based prospective study included 90 young and 130 old patients with acute ischemic stroke. Data regarding the etiology of the stroke, diagnostic test results and degree of functional improvement of patients were examined during their observation. Results: Common causes for stroke in the young patients were current smoking (53.3%), heavy alcohol consumption (51.1%), cardiac embolism (36.0%), migraine with aura (25.5%), infective diseases (15.6%), and oral contraceptive use (14.4%). Leading causes for ischemic stroke in old patients were the conventional risk factors such as hypertension (75.4%), atherosclerosis (66.9%), and diabetes mellitus (26.9%). Most of the young stroke patients demonstrated good functional outcomes, at the time of discharge (71.1%) and at three weeks (86.6%) according to the Rankin Scale. Conclusion: There are significant differences between young and old patients with ischemic stroke regarding to risk factors, etiological subtypes and improvement of functional deficits associated with the stroke.
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    Etiology and Risk Factors of Ischemic Stroke in Young Adults: A Mongolian Two-Center Study
    (2023-07-27) ; ;
    Tsagaankhuu Guntev
    Introduction: Young adults experiencing ischemic stroke often present with distinct risk factors and underlying causes that are less prevalent or different compared to older individuals. However, the existing classifications may not fully capture the unique risk and etiological factors specific to young adults. In this study, we utilized a modified risk factor categorization derived from the International Pediatric Stroke Study (IPSS) to analyze the risk factor profiles of Mongolian young patients diagnosed with ischemic stroke. Methods: This study is a retrospective analysis conducted at two medical centers. We included patients between the ages of 18 and 49 years who were admitted to the First and Third Central Hospitals of Ulaanbaatar for their first-ever ischemic stroke during the period from 2018 to 2021. The study aimed to consecutively collect and analyze the risk factors of these patients, which were subsequently categorized into 10 groups based on the modified IPSS criteria. We also examined the potential differences in risk factor distribution based on both sex and age, thereby exploring any notable variations among these patient subgroups. Results: The study included a total of 306 patients, with a median age of 42 years, and 60.5% of the participants were men. Among all patients, at least one IPSS risk factor category was identified in 91.5% of the cases. The most common IPSS subtype observed was atherosclerosis-related risk factors, accounting for 81% of the cases followed by cardiac disorders (16%), chronic systemic conditions (13.1%), arteriopathy (11.4%), and chronic head and neck disorders (6.2%). The prevalence of chronic systemic conditions was higher in patients aged below 35 years (16.7% vs. 11.4%) and in women (21.5% vs. 7.6%, p < 0.05). Atherosclerosis-related risk factors were more dominant in patients aged 35 years and older (87.1% vs. 67.7%, p < 0.0001) and in men (93.0% vs. 62.8%, p < 0.0001). Conclusions: The IPSS classification has the potential to serve as an effective tool in identifying the risk factors associated with ischemic stroke in young adults
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    Efficacy and Safety of Thrombolytic Therapy in Mongolian Young Adults with Acute Ischemic Stroke
    (Mongolian National University of Medical Sciences, 2023-06-30) ; ;
    Banzrai, Chimedlkham
    ;
    Guntev, Tsagaankhuu
    Objectives: The study aimed to assess the safety and efficacy of intravenous thrombolysis (IVT) in Mongolian young patients with acute ischemic stroke (AIS).Methods: Data of 30 AIS patients aged <50 years who were treated with IVT between 2013 and 2023 at the Stroke Department of Third Central Hospital were retrospectively analyzed. For outcome comparison, 60 controls with AIS not treated with IVT and 60 older controls (>50 years) treated with IVT matched age, gender and baseline NIHSS score were selected. Functional outcome at three (3) months defined as “Favorable” and “Unfavorable” (modified Rankin Scale score 0-1 vs 2-6). Symptomatic intracerebral hemorrhage (sICH) was defined according to the SITS-MOSTStudy.Results: “Favorable” outcome at 3 months was significantly higher in young IVT-treated patients (53.3% vs 30.0%, p < 0.05) compared with their matched young and older controls treated with IVT (53.3% vs 26.7%, p = 0.019). The sICHoccurred in 3% of young IVT-treated patients and in 5% of older controls but this difference was nonsignificant. Mortality rate was 21.7% (p = 0.245) among older controls, whereas in young IVT-treated and matched young controls 10% during the 3months follow-up.Conclusions: IVT is safe and beneficial for Mongolian young adults with AIS.
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