Incidence and Prognosis of Pediatric Stroke in Denmark: A Nationwide Population-Based Study.

IF 7.7 1区医学 Q1 CLINICAL NEUROLOGY

Neurology Pub Date : 2025-07-17 DOI:10.1212/wnl.0000000000213901

Julie Brix Bindslev,Jan Brink Valentin,Søren P Johnsen,John Hauerberg,Klaus Hansen,Christina Engel Hoei-Hansen,Thomas Truelsen

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Abstract

BACKGROUND AND OBJECTIVES The aim of this study was to estimate incidence rates, changes in incidence rates, and prognosis of pediatric stroke in Denmark from 2013 to 2020. METHODS Through a nationwide register, we identified all children (age 29 days-17 years) registered with a first-ever stroke or stroke-related diagnosis between 2013 and 2020. Possible stroke events were validated by medical record review. Age-adjusted incidence rates and absolute changes in incidence rates were estimated by Poisson regression analysis. Kaplan-Meier analysis was used to estimate 30-day, 1-year, and 5-year cumulative mortality risks. RESULTS Between 2013 and 2020, the age-adjusted stroke incidence rate increased in male individuals while no change was noted in female individuals. The trend observed in male individuals was driven by the increased incidence rate of arterial ischemic stroke (AIS) (yearly absolute change per 100,000 person-years: 0.14, 95% CI 0.018-0.26). The 30-day, 1-year, and 5-year cumulative mortality risks were 7.7% (95% CI 4.2-11.2), 10.0% (95% CI 6.0-13.9), and 11.0% (95% CI 6.8-15.2), respectively. Mortality risk remained stable over time (p value = 0.77). Among children alive at follow-up, moderate-severe neurologic impairment was present in 20.2% with AIS and 23.1% with intracerebral hemorrhage. DISCUSSION From 2013 through 2020, the age-adjusted incidence rate of pediatric stroke increased in male individuals while remaining stable in female individuals. Morbidity and mortality after stroke were substantial, highlighting the need for further improvements in pediatric stroke management.

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丹麦儿童脑卒中的发病率和预后：一项基于全国人群的研究。

背景与目的本研究的目的是估计2013年至2020年丹麦儿童卒中的发病率、发病率变化和预后。方法：通过全国范围的登记，我们确定了2013年至2020年间首次卒中或卒中相关诊断的所有儿童（29天-17岁）。可能的卒中事件通过医疗记录审查进行验证。通过泊松回归分析估计年龄调整后的发病率和发病率的绝对变化。Kaplan-Meier分析用于估计30天、1年和5年累积死亡风险。结果2013 - 2020年，男性经年龄调整后的脑卒中发病率呈上升趋势，而女性无明显变化。在男性个体中观察到的趋势是由动脉缺血性卒中（AIS）发病率增加所驱动的（每10万人年的年绝对变化：0.14,95% CI 0.018-0.26）。30天、1年和5年累积死亡风险分别为7.7% （95% CI 4.2-11.2）、10.0% （95% CI 6.0-13.9）和11.0% （95% CI 6.8-15.2）。死亡风险随时间保持稳定（p值= 0.77）。在随访时存活的儿童中，20.2%的AIS患者存在中度至重度神经功能障碍，23.1%的脑出血患者存在神经功能障碍。从2013年到2020年，儿童卒中的年龄调整发病率在男性个体中增加，而在女性个体中保持稳定。卒中后的发病率和死亡率都很高，这表明需要进一步改善儿童卒中管理。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Neurology 医学-临床神经学

CiteScore

12.20

自引率

4.00%

发文量

1973

审稿时长

2-3 weeks

期刊介绍： Neurology, the official journal of the American Academy of Neurology, aspires to be the premier peer-reviewed journal for clinical neurology research. Its mission is to publish exceptional peer-reviewed original research articles, editorials, and reviews to improve patient care, education, clinical research, and professionalism in neurology. As the leading clinical neurology journal worldwide, Neurology targets physicians specializing in nervous system diseases and conditions. It aims to advance the field by presenting new basic and clinical research that influences neurological practice. The journal is a leading source of cutting-edge, peer-reviewed information for the neurology community worldwide. Editorial content includes Research, Clinical/Scientific Notes, Views, Historical Neurology, NeuroImages, Humanities, Letters, and position papers from the American Academy of Neurology. The online version is considered the definitive version, encompassing all available content. Neurology is indexed in prestigious databases such as MEDLINE/PubMed, Embase, Scopus, Biological Abstracts®, PsycINFO®, Current Contents®, Web of Science®, CrossRef, and Google Scholar.