Predictors of survival and characteristics of childhood stroke

To determine predictors of outcome we reviewed 226 medical records of patients admitted to Children's National Medical Center with the diagnosis of cerebrovascular disease from 1978 to 1988. Ninety-five cases of stroke were identified by either neuroimaging techniques (87), autopsy (7), or clinical examination (1). Causal factors implicated in 89% of the patients included infectious (21%), vascular (18%), hematologic (15%), cardiac (13%) problems, minor trauma (8%) or miscellaneous (14%) causes. Patient outcome (n = 88) included residual impairment in 54%, complete resolution of their initial deficit in 23%, and death in 23%. Among patients with abnormal CT findings (n = 60), a logistic regression model revealed that patients with hemorrhage were at a significant risk (p = 0.0469) for death (odds ratio (OR) = 5.5, 95% confidence interval (CI) 1.2-24.5); those with an altered level of consciousness (stupor or coma) on presentation were also at risk (p = 0.0166; OR = 6.94, CI 1.7-28.5). The sensitivity and specificity of this model were 57% and 93%, respectively. No other clinical, laboratory, or demographic variable analyzed was predictive of outcome.