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Pediatric stroke: clinical characteristics, acute care utilization patterns, and mortality

Kimberly D Statler1, Li Dong, Denise M Nielsen

  • 1Department of Pediatrics, University of Utah, PO Box 2581289, 295 Chipeta Way, Salt Lake City, UT 84158, USA. kim.statler@hsc.utah.edu

Child'S Nervous System : Chns : Official Journal of the International Society for Pediatric Neurosurgery
|October 6, 2010
PubMed

Insights

Acute care for pediatric stroke shows similar utilization by stroke type, but Children's Hospitals provide more intensive and aggressive treatments. Despite this, in-hospital mortality for pediatric stroke remains high.

Area of Science:

  • Pediatric Neurology
  • Healthcare Utilization Research
  • Clinical Informatics

Background:

  • Acute care patterns for pediatric stroke are not well-defined, hindering effective care coordination and treatment strategies.
  • Understanding these patterns is crucial for improving outcomes in children with stroke.

Purpose of the Study:

  • To describe demographics and clinical characteristics of pediatric stroke patients.
  • To compare acute care utilization between hemorrhagic and ischemic stroke, and between Children's and non-Children's Hospitals.
  • To identify factors linked to aggressive care and in-hospital mortality.

Main Methods:

  • Retrospective cohort analysis of the Kids Inpatient Database for children hospitalized with stroke.
  • Comparison of demographics, predisposing conditions, and intensive/aggressive care by stroke and hospital type.
  • Logistic regression to identify factors associated with aggressive care and in-hospital mortality.

Main Results:

  • Hemorrhagic stroke (43%) was more common in younger children and had higher mortality. Ischemic stroke was more frequent in older children with predisposing conditions.
  • Intensive (30%) and aggressive (15%) care rates were low, similar by stroke type, but higher at Children's Hospitals.
  • Aggressive care was associated with older age, hemorrhagic stroke, predisposing conditions, and Children's Hospital treatment. Hemorrhagic stroke and aggressive care correlated with in-hospital mortality.

Conclusions:

  • Acute care utilization for pediatric stroke is similar across stroke types, yet intensive and aggressive care are more prevalent in Children's Hospitals.
  • In-hospital mortality rates for pediatric stroke remain concerningly high.
  • Adopting established treatment guidelines, similar to adult stroke care, may standardize treatment and improve outcomes for pediatric stroke patients.
Abstract

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