Response to Letter Regarding Article, “Long-Term Mortality After First-Ever and Recurrent Stroke in Young Adults”

We thank Rutten-Jacobs and De Leeuw of their kind remarks on our recent article of long-term mortality after young stroke.1 In this article, we compared the mortality rates of young ischemic stroke patients with the general population using the standardized mortality ratio (SMR). We observed an increased mortality rate for young ischemic stroke patients as did Rutten-Jacobs et al in their previous study.2 We discussed that the SMR in our study was almost twice as high as in their study. In their letter, Rutten-Jacobs and De Leeuw write that it can be problematic to compare SMRs between different study populations as each study population’s SMR is based on its own sets of weights determined by the age, sex, and calendar-year structure of the study. We do agree that it would have been best not to compare the exact SMRs of these 2 different studies because of different study populations.Rutten-Jacobs and De Leeuw also suggest that there is a difference …