Epidemiology and Outcomes of Arterial Ischemic Stroke in Children: The Canadian Pediatric Ischemic Stroke Registry

deVeber, Gabrielle; Kirton, Adam; Booth, Frances A.; Yager, Jerome Y.; Wirrell, Elaine; Wood, Ellen; Shevell, Michael; Surmava, Ann Marie; McCusker, Patricia; Massicotte, M. Patricia; MacGregor, Daune; Macdonald, Eilidh; Meaney, Brandon; Levin, Simon; Lemieux, Bernard; Jardine, Lawrence; Humphreys, Peter; David, Michèle; Chan, Anthony; Buckley, David; Björnson, Bruce

doi:10.1016/j.pediatrneurol.2017.01.016

Cited by 225 publications

(261 citation statements)

References 43 publications

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“…This review will focus on childhood AIS (age 29 days of life to 18 years) with brief comments on perinatal stroke, for which antithrombotic agents are rarely recommended . The annual incidence of childhood AIS is estimated at 1.7 to 13 in 100 000 children in North America with in‐hospital mortality around 3% . AIS is more common than primary hemorrhagic stroke for all ages but accounts for 55% of all pediatric strokes compared with 80% to 85% in adults .…”

Section: Epidemiologymentioning

confidence: 99%

Aspirin in childhood acute ischemic stroke: The evidence for treatment and efficacy testing

Boucher

Taylor

Luchtman‐Jones

2019

Pediatric Blood & Cancer

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Aspirin is the most commonly prescribed antiplatelet agent worldwide, but evidence supporting its use varies by age and disease process. Despite its frequent use in childhood acute ischemic stroke prevention and management, major knowledge gaps exist about optimal pediatric aspirin use, particularly in this setting, where high‐quality clinical trials are urgently needed. This review focuses upon the evidence for aspirin use in childhood acute ischemic stroke, includes a summary of aspirin pharmacology to highlight misconceptions and common clinical situations which may limit its efficacy, and discusses the techniques and potential role of laboratory monitoring of aspirin efficacy in children.

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Section: Epidemiologymentioning

confidence: 99%

Aspirin in childhood acute ischemic stroke: The evidence for treatment and efficacy testing

Boucher

Taylor

Luchtman‐Jones

2019

Pediatric Blood & Cancer

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“…Универсальность оказываемой помощи обеспечивалась доставкой в данные госпитали детей с тяжелыми диагнозами, в том числе инсультами. В период с января 1992 г. по декабрь 2001 г. в регистр были включены 1454 ребенка с ИИ в возрасте от рождения до 18 лет (1129 детей с артериальным ИИ и 325 детей с церебральным венозным тромбозом) [13]. Для каждого включенного в регистр ребенка документировали следующую информацию: демографические данные, клиническая картина и диагноз, тип инсульта, данные нейровизуализации, факторы риска и связанные с возникновением инсульта состояния («ассоциации»), категоризированные на артериопатии, заболевания сердца, связанные с протромбическими факторами заболевания, острые состояния или хронические заболевания, а также применяемое лечение и исходы инсульта.…”

Section: российский регистр инсультаunclassified

“…Мальчики имели более высокий риск возникновения инсультов, чем девочки (RR 1,25; ДИ 1,11-1,40; p = 0,0002), и повышенный риск инсульта сохранялся у них даже при устранении фактора травмы. По сравнению с девочками мальчики имели и более высокую летальность от ИИ (17 % против 12 %, р = 0,002) [13].…”

Section: российский регистр инсультаunclassified

Stroke in children. Formation of the pediatric register: international and regional experience

Щедеркина¹,

Vitkovskaya²,

Колтунов³

et al. 2018

Rus. ž. det. nevrol.

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“…International incidence rates for pediatric stroke and TIA varies widely, from 0.54 to 13 per 100,000 children per year under 18 years of age [1,2], thereby supporting the need for determining the predictive values of codes for identifying pediatric stroke and TIA. In North America, reported incidence rates range from 0.54 to 4.7 per 100,000 children [3].…”

Section: Introductionmentioning

confidence: 99%

Incidence and Current Treatment Gaps in Pediatric Stroke and TIA: An Ontario-Wide Population-Based Study

et al. 2019

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Background: Reported incidence rates of pediatric stroke and transient ischemic attack (TIA) range widely. Treatment gaps are poorly characterized. We sought to evaluate in Ontario, the incidence and characteristics of pediatric stroke and TIA including care gaps and the predictive value of International Classification of Diseases (ICD) codes. Methods: A retrospective chart review was conducted at 147 Ontario pediatric and adult acute care hospitals. Pediatric stroke and TIA cases (age < 18 years) were identified using ICD-10 code searches in the 2010/11 Canadian Institute for Health Information’s Discharge Abstract Database (CIHI-DAD) and National Ambulatory Care Reporting System (NACRS) databases in the Ontario Stroke Audit. Results: Among 478 potential pediatric stroke and TIA cases identified in the CIHI-DAD and NACRS databases, 163 were confirmed as cases of stroke and TIA during the 1-year study period. The Ontario stroke and TIA incidence rate was 5.9 per 100,000 children (3.3 ischemic, 1.8 hemorrhagic and 0.8 TIA). Mean age was 6.4 years (16% neonate). Nearly half were not imaged within 24 h of arrival in emergency and only 56% were given antithrombotic treatment. At discharge, 83 out of 121 (69%) required health care services post-discharge. Overall positive predictive value (PPV) of ICD-10 stroke and TIA codes was 31% (range 5–74%) and yield ranged from 2.4 to 29% for acute stroke or TIA event; code I63 achieved maximal PPV and yield. Conclusion: Our population-based study yielded a higher incidence rate than prior North-American studies. Important care gaps exist including delayed diagnosis, lack of expert care, and departure from published treatment guidelines. Variability in ICD PPV and yield underlines the need for prospective data collection and for improving the pediatric stroke and TIA coding processes.

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Epidemiology and Outcomes of Arterial Ischemic Stroke in Children: The Canadian Pediatric Ischemic Stroke Registry

Cited by 225 publications

References 43 publications

Aspirin in childhood acute ischemic stroke: The evidence for treatment and efficacy testing

Aspirin in childhood acute ischemic stroke: The evidence for treatment and efficacy testing

Stroke in children. Formation of the pediatric register: international and regional experience

Incidence and Current Treatment Gaps in Pediatric Stroke and TIA: An Ontario-Wide Population-Based Study

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