Abstract 8722: Temporal Trends in Incidence of Stroke Among Children: a 14-Year Statewide Study

• Published in: Circulation (New York, N.Y.) N.Y.), 2011-11, Vol.124 (suppl_21)
• Main Authors: Gandhi, Sampada K, McKinney, James S, Sedjro, Jeanine E, Cheng, Jerry Q, Deng, Yingzi, Cosgrove, Nora M, Cabrera, Javier, Kostis, John B
• Format: Article
• Language: English
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/circ.124.suppl_21.A8722

Abstract only Objectives: Although a rare condition, stroke is one of the top 10 causes of death among children. However, little is known about current trends in the incidence of pediatric stroke. We examined all hospitalizations with a diagnosis of stroke in children admitted to all non-federal New Jersey hospitals from 1994-2007. Methods: Children (age >30 days to ≤19 years) admitted with a primary or secondary diagnosis of stroke for the first time were included in the analysis. Demographic and clinical information were assessed using the Myocardial Infarction Data Acquisition System (MIDAS) statewide database. Results: During the 14 year study period, 1,034 children were admitted with a first time hospitalized stroke. The time trend of incidence followed a quadratic function where the rate decreased from 1994 to a nadir at 1999-2001 and increased after this year (p=0.0003). Interestingly, this parabolic relationship could be explained by two factors: better treatment of sickle cell disease with blood transfusions after year 1998 (p=0.0001), and an improved diagnostic accuracy with increasing use of diffusion-weighted MRI since 2001 (p=0.0002). In addition, increased prevalence of hypertension and obesity among children, better awareness of stroke and more referrals of young patients to neurologists may have contributed to the rise in the incidence of pediatric stroke in recent years. When strokes were categorized into ischemic and hemorrhagic, the incidence of the former showed a quadratic trend mimicking the overall shape described above (p=0.0001), while the incidence of hemorrhagic stroke remained stable during the study period (p=0.12). Conclusion: After an initial decrease concurrent with changes in treatment of sickle cell disease, the incidence of pediatric stroke is on the rise due to more widespread use of diffusion-weighted MRI and increased prevalence of hypertension and obesity.