Almost 3 percent of infants and children hospitalized for pediatric arterial ischemic stroke (AIS) die in the hospital, according to a new international study published in the May 2018 edition of Pediatrics.
Risk factors for mortality in pediatric patients exhibiting ischemic stroke are not well understood. But the researchers said differences in mortality may be associated with geographic location, gender and race.
Led by first author Lauren A. Beslow, MD, MSCE, of the Children’s Hospital of Philadelphia, the researchers sought to determine the risk factors of in-hospital mortality after pediatric AIS.
“We leverage one of largest prospective pediatric stroke registries available and have confirmed risk factors for mortality found in single-site studies as well as identified risk factors for in-hospital mortality that have not previously been reported,” Beslow and colleagues wrote.
They enrolled 915 neonates (infants less than four weeks old) and 2,273 children (ages one month to 18 years) with AIS from 87 hospitals in 24 countries. Of 84 deaths, 48 had a reported cause—almost 65 percent were stroke related and the remaining deaths, the researchers said, were caused by disease. The researchers also the found:
- Approximately 1.5 percent of infants and 3.1 percent of children died during hospitalizations for ischemic stroke.
- Congenital heart disease, posterior plus anterior circulation stroke and stroke presentation without seizures were associated with in-hospital mortality for neonates.
- Hispanic ethnicity, congenital heart disease and posterior plus anterior circulation stroke were associated with in-hospital mortality for children.
- The average yearly in-hospital mortality was almost three deaths per 100 stroke cases.
“Physicians including neonatologists, pediatric intensivists, and hospitalist pediatricians who care for pediatric patients with AIS may use the information in this report to aid recognition of those who may be at high risk for deterioration and death,” Beslow et al. wrote.
The researchers noted additional studies are needed to understand reasons for ethnic disparities and to develop improved neuroprotective strategies for children with severe AIS.
As a senior news writer for TriMed, Subrata covers cardiology, clinical innovation and healthcare business. She has a master’s degree in communication management and 12 years of experience in journalism and public relations.