Epidemiology, risk factors and characteristics of pediatric stroke: a nationwide population-based study

Kl, Chiang; Chen, Cheng

doi:10.1093/qjmed/hcy066

Cited by 35 publications

(42 citation statements)

References 39 publications

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“…In very young adults with AIS, aged 18-35 years, dyslipidemia was observed in 37% of them while hypertension was present only in 9% of cases [29]. On the other hand, metabolic disorders, including hyperlipidemia were observed in 2.3% of Taiwanese children with ischemic stroke in a nationwide population study [30]. Interestingly, the study by Bigi et al [31] demonstrated that hyperlipidemia concerned 11 out of 128 children with AIS (aged up to 16 years), as well as 54 young adults (aged 16-45 years), out of 199 analyzed patients and the difference was statistically significant.…”

Section: Discussionmentioning

confidence: 94%

Levels of Lipid Parameters in Children with Arterial Ischemic Stroke and Headache: Case-Control Study and Meta-Analysis

et al. 2021

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Background: Abnormalities in levels of lipid parameters are one of the main causes of cardiovascular and cerebrovascular disease in adults. There are limited data on the role of disturbances of lipid metabolism in the etiopathogenesis of arterial ischemic stroke (AIS) in children and the results provided are ambiguous. The aim of the study was to compare the levels of lipid parameters (total cholesterol [TC], triglycerides [TG], high-density lipoprotein [HDL] and low-density lipoprotein [LDL]) between children with AIS, children with headache and healthy children. In addition, we performed meta-analysis of available data on lipid parameters in young patients with AIS. Methods: We retrospectively analyzed 218 children hospitalized between 2002 and 2018 in the Upper-Silesian Child’s Health Center (n = 82 children with AIS, n = 45 children with headache, n = 91 healthy children) with available data on lipid levels, i.e., TC, TG, and HDL. The levels of LDL, non-HDL cholesterol, and a very-low density lipoprotein (VLDL) were calculated. The ratios of TC/HDL, TG/HDL and LDL/HDL were also assessed. Data between cases and controls were analyzed using STATISTICA 13.0 whereas meta-analysis was performed with RevMan version 5.4 software. Results: Children with headache were significantly older than children with AIS (p = 0.001). Ten percent of children with AIS had posterior stroke. The mean TC level was significantly higher in the AIS children than in controls or in children with headache. Mean TG and VLDL levels were significantly different between all groups (p < 0.001 each). The hypertriglyceridemia was more prevalent in AIS children than in children with headache (39% vs. 13%, OR = 4.16 95% CI 1.58–10.94, p = 0.004). Similarly, the frequency of dyslipidemia was higher in children with AIS compared to children with headache (38% vs. 22%, OR = 2.13 95% CI 0.93–4.89, p = 0.078). The meta-analysis was conducted based on data from 4 studies (3 studies published previously plus the results we obtained in the present case-control analysis) with total number of 236 young patients with AIS and 272 healthy controls. Significant Standard Mean Difference (SMD) was found in triglycerides level between young patients with AIS and controls (0.78 95%CI 0.30–1.26 p = 0.002). Conclusions: Lipid abnormalities, especially levels of triglycerides, seem to be of particular importance in children with AIS, as confirmed in meta-analysis. The results of the present study may be a significant contribution to the further research on the role of lipid metabolism disorders in the development of childhood stroke.

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Section: Discussionmentioning

confidence: 94%

Levels of Lipid Parameters in Children with Arterial Ischemic Stroke and Headache: Case-Control Study and Meta-Analysis

et al. 2021

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“…As per the Canadian Pediatric Ischemic Stroke Registry data (N = 1,129), a stroke-specific mortality rate of 5% was observed in children with PAIS [ 4 ]. A mortality rate of 10.5% was seen in PIS patients in a nationwide population-based study in Taiwan [ 8 ]. Simonetti et al's study based on the Swiss NeuroPaediatric Stroke Registry (N = 116) found long-term mortality of 14% in children with PAIS [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

“…Mortality rates of 10.5% were seen with PIS in a nationwide population-based study enrolling 685 pediatric stroke cases with 36.1% PIS cases in Taiwan [8]. According to a Kids' Inpatient Database study, PIS has a hospitalization rate of 3.7 per 100,000 children, with the highest rates seen in children under four years of age and those between 15-20 years of age [9].…”

Section: Introductionmentioning

confidence: 99%

Cardiovascular and Hematological Risk Factors and Mortality Risk in Pediatric Arterial Ischemic Stroke: Analysis Report From Hospitals in the United States

Beriwal¹,

Imran²,

Okotcha³

et al. 2020

Cureus

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We aimed to analyze the differences in demographics, comorbidities, and the risk of in-hospital mortality in pediatric arterial ischemic stroke (PAIS) inpatient population by hematological (HEM) and cardiovascular (CV) risk factors. Methods A total of 4,036 inpatients (1-18 years of age) from the Nationwide Inpatient Sample (NIS) with a primary diagnosis of PAIS were included. Descriptive statistics, linear-by-linear association test, and logistic regression models were utilized to analyze differences in demographics, comorbidities, and their impact on mortality in PAIS inpatients by CV and HEM risk factors. Results The cumulative in-hospital mortality rate in the entire PAIS inpatient cohort was 3.6%. The mortality rate was higher in the CV cohort (57.4%) as compared to the HEM cohort (29.7%). When compared with the cohort with no risk factors, HEM and CV were associated with four times (95% CI: 2.36-8.03) and seven (95% CI: 4.03-12.61) times higher odds for in-hospital mortality respectively. CV risk factors like cardiomyopathy and diabetes, and HEM risk factors like blood disorders, coagulation disorders, and deficiency anemias were associated with a significantly increased risk of in-hospital mortality. Conclusion The in-hospital mortality risk in PAIS patients was increased by 613% by CV risk factors and by 336% by HEM risk factors. Early identification and effective management of associated CV and HEM risk factors in the PAIS patient population can pave the way for increased survival and improved clinical outcomes.

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“…Haemorrhagic stroke is defined as non-traumatic intracranial haemorrhage which can be subdivided into intracerebral, subarachnoid and intraventricular haemorrhage. The incidence of haemorrhagic stroke lies between 1-3.2 per 100,000 per year and it accounts for approximately 50% of all childhood strokes (2)(3)(4)35,36).…”

Section: Epidemiology and Risk Factorsmentioning

confidence: 99%

Neurovascular disorders in children: an updated practical guide

Sinha¹,

Ramji²

2021

Transl Pediatr

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Stroke is defined by the WHO as a rapid deterioration in neurological symptoms lasting more than 24 hours with a vascular origin (1). It is an important cause of longterm morbidity and mortality in children. The incidence of childhood stroke varies amongst different population studies and lies between 2-13 per 100,000 (2-4).Paediatric stroke is classified as either perinatal (≤28 days of age) or childhood (>28 days of age) (5). The focus of this article will be on childhood stroke.Childhood stroke can be further subdivided into ischaemic and haemorrhagic stroke (Figure 1). Ischaemic stroke encompasses both arterial ischaemic stroke (AIS) and venous infarction secondary to cerebral venous sinus thrombosis (CVST) or cortical vein thrombosis (6). CVST is frequently accompanied by areas of parenchymal haemorrhage. AIS Epidemiology and risk factorsPaediatric stroke is classified as either perinatal/neonatal (28 days of age) or childhood (>28 days of age). The definition of AIS is shown in Table 1.The major risk factors that cause adult strokes such as atherosclerosis and associated conditions such as hypertension and dyslipidaemia are irrelevant in childhood. The aetiology of AIS in childhood differs from adults, is complex and more often multifactorial. The age of the child is also an important factor with stroke in the neonatal stage having a unique set of considerations to strokes in an older Review Article on Pediatric Neuroradiology for Trainees and Fellows: An Updated Practical Guide

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Epidemiology, risk factors and characteristics of pediatric stroke: a nationwide population-based study

Cited by 35 publications

References 39 publications

Levels of Lipid Parameters in Children with Arterial Ischemic Stroke and Headache: Case-Control Study and Meta-Analysis

Levels of Lipid Parameters in Children with Arterial Ischemic Stroke and Headache: Case-Control Study and Meta-Analysis

Cardiovascular and Hematological Risk Factors and Mortality Risk in Pediatric Arterial Ischemic Stroke: Analysis Report From Hospitals in the United States

Neurovascular disorders in children: an updated practical guide

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