Abstract 8724: Short and Long-Term Mortality of Pediatric Stroke: A Fourteen Year Statewide Study
Objectives: Since there are no recent data on the short and long-term mortality of pediatric stroke, we examined the 30-day, 1 year and 5 year mortality of children admitted to New Jersey (NJ) hospitals with a diagnosis of stroke using a statewide administrative database.
Methods: We used the Myocardial Infarction Data Acquisition System (MIDAS) database, which includes demographic and clinical data on children (aged > 30 days to ≤ 19 years) admitted with a first time diagnosis of stroke to all non-federal hospitals in NJ between 1994 and 2007. Deaths were ascertained by matching the MIDAS records to death information from NJ Death Registration Files within 30 days, 1 year and 5 years from the index admission. Cox proportional hazards regression models were fitted to assess the effect of demographic characteristics and predisposing conditions of stroke on time to death.
Results: Thirty-day, 1-year and 5-year mortality rates were 10.2%, 13.7% and 16.2% respectively (Figure 1a) among 1,034 children admitted during the study period. At all time periods, mortality rates from hemorrhagic stroke were 2-3 times higher compared to ischemic stroke and adjusted survival from hemorrhagic stroke was significantly lower compared to ischemic stroke (p< 0.0001) (Figure 1b, 1c, 1d). Twenty-four percent of the deaths were due to a cardiovascular cause, mostly comprising of cerebrovascular hemorrhage and congenital malformations of the circulatory system. The remaining 76% percent of the deaths were due to a non-cardiovascular cause such as cancer, diseases or malformations of nervous system. After adjusting for all covariates, important predictors of mortality were: type of stroke, prior history of cardiac dysrhythmia, CNS tumor, leukemia, human immunodeficiency virus (HIV) and meningitis.
Conclusion: At 5 years, roughly 85% of the children with stroke were alive. However, children with hemorrhagic stroke were at a much higher risk of death compared to those with ischemic stroke.
- © 2011 by American Heart Association, Inc.