Evidence map›Paper›PMID 40178096›Full record

SynthesisJournal of the American Heart Association2025

Return to Work After Ischemic Stroke in Young Adults: A Multicenter Cohort Study, Systematic Review, and Meta-Analysis.

Gabriel Yi Ren Kwok, Nicole Yeong, Michelle Law, Zi Lun Kang, Arjun Achar, Xin Yuan Lim, Megan B J Ng, Yao-Hao Teo, Sarah M L Tan, Jamie S Y Ho and 9 more

Abstract readSystematic ReviewMeta-AnalysisMulticenter Study
In one paragraph

Synthesis in Journal of the American Heart Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Article
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  5. Observational
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

Gabriel Yi Ren KwokBarts and The London School of Medicine and Dentistry, Queen Mary University of London London UK.ORCID 0000-0001-6849-6098
Nicole YeongYong Loo Lin School of Medicine, National University of Singapore Singapore Singapore.
Michelle LawYong Loo Lin School of Medicine, National University of Singapore Singapore Singapore.
Zi Lun KangYong Loo Lin School of Medicine, National University of Singapore Singapore Singapore.
Arjun AcharSt George's University of London London UK.
Xin Yuan LimYong Loo Lin School of Medicine, National University of Singapore Singapore Singapore.ORCID 0000-0001-5088-8130
Megan B J NgDivision of Neurology, Department of Medicine National University Hospital Singapore Singapore.ORCID 0000-0002-1196-6164
Yao-Hao TeoYong Loo Lin School of Medicine, National University of Singapore Singapore Singapore.ORCID 0000-0003-0439-4097
Sarah M L TanDivision of Neurology, Department of Medicine National University Hospital Singapore Singapore.ORCID 0000-0001-7528-8414
Jamie S Y HoDivision of Neurology, Department of Medicine National University Hospital Singapore Singapore.ORCID 0000-0002-1180-6902
Maznah MarminDivision of Neurology, Department of Medicine Ng Teng Fong General Hospital Singapore Singapore.
Fadhlina HassanDivision of Neurology, Department of Medicine Ng Teng Fong General Hospital Singapore Singapore.
Magdalene L J ChiaDivision of Neurology, Department of Medicine Ng Teng Fong General Hospital Singapore Singapore.
Lily Y H WongDivision of Neurology, Department of Medicine National University Hospital Singapore Singapore.ORCID 0000-0002-6772-9053
Ching-Hui SiaYong Loo Lin School of Medicine, National University of Singapore Singapore Singapore.ORCID 0000-0002-2764-2869
Vijay K SharmaYong Loo Lin School of Medicine, National University of Singapore Singapore Singapore.
Leonard L L YeoYong Loo Lin School of Medicine, National University of Singapore Singapore Singapore.ORCID 0000-0002-4249-0402
Aftab AhmadDivision of Neurology, Department of Medicine Ng Teng Fong General Hospital Singapore Singapore.ORCID 0000-0003-2141-175X
Benjamin Y Q TanYong Loo Lin School of Medicine, National University of Singapore Singapore Singapore.ORCID 0000-0003-1824-9077

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIschemic stroke incidence in young adults is increasing globally, with return to work (RTW) a key rehabilitation goal. We aimed to assess the overall proportions of and factors associated with RTW following young adult ischemic stroke. METHODS AND

resultsWe performed a retrospective cohort study of all patients with ischemic stroke aged 18 to 50 years at 2 tertiary hospitals in Singapore from 2020 to 2022. We evaluated associations between patient characteristics and 3-month RTW status, augmenting these findings with a systematic review and meta-analysis of PubMed, Embase, Scopus, and Cochrane databases from January 2000 to November 2023. We pooled proportions for RTW and functional recovery (defined as a 90-day modified Rankin Scale score of 0-2) and meta-analyzed associations between patient characteristics and RTW using random-effects models. In this multicenter cohort, 68.8% (249/362) of young patients with ischemic stroke returned to work, while 87.8% (318/362) achieved functional recovery. Multivariable logistic regression showed that patients with large-artery atherosclerosis pathogenesis, diabetes, higher admission National Institutes of Health Stroke Scale scores, and higher 90-day modified Rankin Scale had significantly lower odds of RTW. The systematic review and meta-analyses of 1914 patients across 6 cohort studies identified significantly lower odds of RTW in patients with large-artery atherosclerosis, diabetes, and admission National Institutes of Health Stroke Scale SCORE >15. The pooled proportion of RTW was 63.2% (984/1574 [95% CI, 56.0-69.9]) and functional recovery 84.7% (719/846 [95% CI, 81.1-87.8]).

conclusionsPatients with large-artery atherosclerosis, diabetes, and higher admission National Institutes of Health Stroke Scale score at baseline are less likely to RTW. While lower 90-day modified Rankin Scale is significantly associated with RTW, many patients achieving functional recovery do not RTW. Well-designed cohort studies are warranted to explore this disparity.

Indexed as

Ischemic StrokeReturn to WorkStroke RehabilitationAdolescentAdultFemaleHumansMaleMiddle AgedRecovery of FunctionRetrospective StudiesRisk FactorsSingaporeYoung Adultoccupationprognosisstrokeworkyoung

Identifiers

PMID40178096
PMCPMC12132830

What OpenQuestion holds

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LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.