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Is it time for a large, collaborative study of pediatric stroke?
Darin B Zahuranec1, Devin L Brown, Lynda D Lisabeth
1University of Michigan Medical School, 1500 E Medical Center Dr, Ann Arbor, MI 48109-0316, USA.
Insights
Pediatric stroke incidence in a biethnic community was 4.3 per 100,000 children annually. Rare events necessitate large populations for future childhood stroke risk factor studies.
Area of Science:
- Neurology
- Epidemiology
- Pediatrics
Background:
- A 2002 report highlighted the need for more childhood stroke research.
- Pediatric stroke studies are crucial for understanding and preventing long-term neurological deficits.
Purpose of the Study:
- To determine the incidence rate of pediatric stroke in a biethnic community.
- To calculate the required population size for future prospective pediatric stroke studies.
Main Methods:
- Utilized data from the Brain Attack Surveillance in Corpus Christi (BASIC) project.
- Identified pediatric stroke cases (ages 1 month to 20 years) from hospital discharge codes in 2002-2003.
- Validated cases through source document review and calculated incidence rates.
Main Results:
- Identified 8 pediatric stroke cases, with an annual incidence of 4.3 per 100,000 children.
- All identified strokes occurred in Mexican American children.
- Calculated that up to 59 million children may be needed for future case-control studies within 4 years.
Conclusions:
- Pediatric stroke is a rare condition.
- Future research necessitates multicenter collaborations.
- A national surveillance system may be required for comprehensive pediatric stroke studies.
Background And Purpose:
A 2002 report from the National Institute of Neurological Disorders and Stroke cited the critical importance of more childhood stroke studies. We present the incidence rate of pediatric stroke from a biethnic community-based project and calculate the population size required for future prospective studies of pediatric stroke.
Methods:
This work is part of the Brain Attack Surveillance in Corpus Christi (BASIC) project. The community of 325,000 is located in southeast Texas and is composed of approximately equal numbers of Mexican Americans (MAs) and non-Hispanic whites (NHWs). Discharge diagnosis codes from all hospitals in the county were used to identify cases of childhood stroke (age >1 month and <20 years) in 2002 and 2003, and stroke cases were validated by source document review. On the basis of the incidence rates, the population size required to complete a case-control study to examine risk factors for pediatric stroke was calculated.
Results:
Eight cases of pediatric stroke were identified, yielding an annual incidence rate of 4.3 per 100,000 (95% CI, 1.9 to 8.5). There were 5 cases of intracerebral hemorrhage, 1 subarachnoid hemorrhage, 1 ischemic stroke, and 1 transient ischemic attack. All of the events occurred in MAs. Depending on the prevalence of the risk factors of interest, future studies of pediatric stroke would have to draw from a population of up to 59 million children to complete a case-control study within 4 years.
Conclusions:
Given the rarity of pediatric stroke, future studies will require multicenter efforts and possibly a national surveillance system.
