Risk Factors for Peri-Procedural Arterial Ischaemic Stroke in Children with Cardiac Disease

Area of Science:

• Pediatric Cardiology
• Neurodevelopmental Outcomes
• Pediatric Stroke

Background:

• Improved survival in children with congenital heart disease highlights neurodevelopmental outcomes.
• Nearly half of infants undergoing cardiac surgery experience neurodevelopmental disability.
• Arterial ischaemic stroke (AIS) is a significant concern due to potential permanent neurologic sequelae.

Purpose of the Study:

• To investigate risk factors for peri-procedural arterial ischaemic stroke (AIS) in pediatric patients with cardiac disease.
• To identify specific factors contributing to stroke occurrence following cardiac procedures in children.

Main Methods:

• Retrospective case-control analysis of children (<18 years) with radiologically confirmed AIS after a cardiac procedure.
• Cases were matched with two controls based on cardiac diagnosis, procedure type, age, and procedure date.
• Data collected from medical records and departmental databases for demographics and peri-procedural information.

Main Results:

• Fifty-two cases of AIS were identified.
• Multivariable analysis revealed post-procedural infection (OR 6.1) and length of ICU stay (OR 4.0) as significant risk factors for AIS.
• Both identified risk factors were statistically significant (p < 0.05).

Conclusions:

• Length of ICU stay and post-procedural infection are critical risk factors for AIS in children with cardiac disease.
• These findings underscore the importance of focusing on infection control and optimizing ICU management for stroke prevention.
• Further attention to these modifiable factors may improve neurodevelopmental outcomes in pediatric cardiac patients.