Abstract Details

Title Epidemiology of Acute Ischemic Stroke in Pediatric Age Group: A National Perspective

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) S37 - Stroke Epidemiology: Risk Factors, Incidence, and Unique Populations (1:48 PM-2:00 PM)

Poster/Presentation
Number 005

Objective

Our aim is to determine the epidemiology of Acute Ischemic Stroke (AIS) in pediatric patients from a nationally representative sample database.

Background Pediatric stroke is one of the leading causes of death among children in the United States. It is also associated with significant neurological morbidity which includes cognitive impairment, epilepsy, behavioral difficulties, and neurological deficits. Patients with this condition are reported to have a lower quality of life and higher health care cost. However, very few recent studies describe the burden of AIS in pediatric age group.

Design/Methods

We derived the study cohort from the National Inpatient Sample (NIS) for the years 2006-2016. Pediatric hospitalizations of age below 18 with AIS were identified using International Classification of Diseases (9th Edition) Clinical Modification diagnosis codes (ICD-9-CM) and ICD-10-CM diagnosis codes. We studied data on demographics, clinical presentation, procedures, co-morbidities and patient outcomes. We utilized statistical analysis software (SAS 9.4) for analytic purpose.

Results Out of 4,888,168 AIS hospitalizations during the study period, 8,010(0.16%) were in the pediatric age group. The trend of pediatric AIS against adult admissions remained stable over the study period with p-trend:0.15. 45% pediatric AIS occurred in age > 10. Demographic characteristics showed, 10. 53% were white followed by others (27%) and African-American (20%). IV-tPA were utilized in 207(2.59%) and mechanical thrombectomy in 102(1.28%). 1,837(23%) were discharged to long-term facility. In-hospital mortality was 288(3.6%). Interestingly in-hospital mortality was higher in those who received IV-tPA (6.8% vs 3.4%;p:<0.001). During the hospitalizations, CHF (OR 7.89; 95%CI 2.18-28.59;p<0.001) and septicemia(OR 3.97; 95%CI 1.23-12.80; p<0.001) were highly associated with in-hospital mortality after adjusting with confounding factors.

Conclusions

Our study demonstrates the epidemiological burden, outcomes and predictors of in-hospital mortality of AIS in pediatric populations over the past decade. Better risk stratification for prophylaxis and improving poor outcomes should be the subject of future studies.

Authors/Disclosures
PRESENTER	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
Abhishek Lunagariya, MD	No disclosure on file

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