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Title: University education and cervical artery dissection.
Austin Authors: Kellert, Lars;Grau, Armin;Pezzini, Alessandro;Debette, Stéphanie;Leys, Didier;Caso, Valeria;Thijs, Vincent N ;Bersano, Anna;Touzé, Emmanuel;Tatlisumak, Turgut;Traenka, Christopher;Lyrer, Philippe A;Engelter, Stefan T;Metso, Tiina M;Grond-Ginsbach, Caspar;Kloss, Manja
Affiliation: Stroke Unit, Perugia University Hospital, Perugia, Italy
Department of Neurology, Ludwig Maximilians University, Marchioninistrasse 15, 81377, Munich, Germany
Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany
Department of Neurology, Klinikum Ludwigshafen, Ludwigshafen, Germany
Department of Clinical and Experimental Sciences, Neurology Clinic, University of Brescia, Brescia, Italy
Inserm, Bordeaux Population Health Research Center, UMR 1219, CHU Bordeaux, University of Bordeaux, 33000, Bordeaux, France
Department of Neurology-Memory Clinic, Bordeaux University Hospital, 146 rue Léo Saignat, 33076, Bordeaux, France
Department of Neurology, INSERM U 1171, Degenerative and Vascular Cognitive Disorders, CHU Lille, University of Lille, 59000, Lille, France
Department of Neurology, University of Caen Basse Normandie, INSERM U919, CHU Côte de Nacre, Caen, France
Cerebrovascular Unit IRCCS Foundation C.Besta Neurological Institute, via Celoria 11, Milan, Italy
Department of Clinical Neurosciences, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden
Department of Neurology, Basel University Hospital, University of Basel, Basel, Switzerland
Stroke Division, The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Heidelberg, Victoria, Australia
Department of Neurology, Austin Health, Heidelberg, Victoria, Australia
Neurorehabilitation Unit, University Center for Medicine of Aging and Rehabilitation, University of Basel, Felix Platter Hospital, Basel, Switzerland
Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland
Issue Date: May-2018
Date: 2018-02-24
Publication information: Journal of neurology 2018; 265(5): 1065-1070
Abstract: We investigated whether university education is more likely in cervical artery dissection (CeAD)-patients than in age- and sex-matched patients with ischemic stroke (IS) due to other causes (non-CeAD-IS-patients). Patients from the Cervical Artery Dissection and Ischemic Stroke Patients study with documented self-reported profession before onset of IS due to CeAD (n = 715) or non-CeAD causes (n = 631) were analyzed. In the reported profession, the absence or presence of university education was assessed. Professions could be rated as academic or non-academic in 518 CeAD and 456 non-CeAD patients. Clinical outcome at 3 months was defined as excellent if modified Rankin Scale was 0-1. University education was more frequent in CeAD-patients (100 of 518, 19.3%) than in non-CeAD-IS-patients (61 of 456, 13.4%, p = 0.008). CeAD-patients with and without university education differed significantly with regard to smoking (39 vs. 57%, p = 0.001) and excellent outcome (80 vs. 66%, p = 0.004). In logistic regression analysis, university education was associated with excellent outcome in CeAD-patients (OR 2.44, 95% CI 1.37-5.38) independent of other outcome predictors such as age (OR 0.97, 95% CI 0.84-0.99), NIHSS (OR 0.80, 95% CI 0.76-0.84) and local signs (OR 2.77, 95% CI 1.37-5.57). We observed a higher rate of university education in patients with CeAD compared with non-CeAD patients in our study population. University education was associated with favorable outcome in CeAD-patients. The mechanism behind this association remains unclear.
DOI: 10.1007/s00415-018-8798-7
ORCID: 0000-0002-6614-8417
Journal: Journal of neurology
PubMed URL: 29478223
Type: Journal Article
Subjects: Cervical artery dissection
Ischaemic Stroke
Level of education
Socioeconomic status
University education
Young adults
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