Disparities in pediatric stroke-related mortality in the United States: Insights from the CDC WONDER database

IF 1.8 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Clinical Neuroscience Pub Date : 2025-09-04 DOI:10.1016/j.jocn.2025.111592

Waleed Tariq , Shahzaib Ahmed , Sophia Ahmed , Eeman Ahmad , Neha Waseem , Hoor Ul Ain , Shkaib Ahmad

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引用次数: 0

Abstract

Objective

Stroke is a rare but significant cause of mortality among the pediatric age group. Despite advances in treatment, disparities in stroke-related mortality persist. We aim to analyze stroke-related mortality among pediatric age groups in the US for over two decades. Methods: This retrospective cross-sectional study utilized the CDC WONDER database for stroke-related mortality in children (≤ 14 years). Crude mortality rates (CMRs) and age-adjusted mortality rates (AAMRs) per 100,000 were calculated. Annual percent changes (APC) with 95 % confidence intervals (CI) were determined from Joinpoint regression (Joinpoint Regression Program V 5.2.0). Results: From 1999 to 2020, a total of 15,512 deaths in the United States pediatric-stroke-related mortality were reported. An overall decrease in AAMR was observed, from 1.26 in 1999 to 1.02 in 2020. Males had higher AAMR (1.28) than females throughout the period (1.03). Across regions, the Midwest had the highest AAMR (1.24), followed by the South (1.23), the West (1.17), and the Northeast (0.95). Non-Hispanic (NH) Black or African American group had the highest AAMR (1.97) followed by Hispanic or Latinos (1.08), NH Whites (1.00), and NH Asian or Pacific Islanders exhibited the lowest AAMR (0.94). The CMR per 100,000 was noted to be the highest for the <1 year age group (CMR: 8.14) while the 5–14 years group demonstrated the lowest crude rate (CMR: 0.56). Upon urbanization, the highest AAMR was observed in large central metro areas (1.23) while large fringe metro areas had the lowest AAMR (1.02). The highest AAMRs state-wise were observed in Alaska (1.79), South Dakota (1.77), and the District of Columbia (1.75). Conclusion: An increase in mortality trends was observed from 2012 onwards with males, infants, and African American children being the high-risk groups. A multifaceted approach, focusing on prevention, early recognition, and optimized management is required to mitigate pediatric-stroke-related mortality.

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美国儿童中风相关死亡率的差异：来自CDC WONDER数据库的见解

目的：中风是一种罕见但重要的儿童死亡原因。尽管治疗取得了进步，但与中风相关的死亡率仍然存在差异。我们的目的是分析在美国儿科年龄组中风相关的死亡率超过二十年。方法：本回顾性横断面研究利用疾病预防控制中心WONDER数据库的儿童（≤14岁）卒中相关死亡率。计算每10万人的粗死亡率（CMRs）和年龄调整死亡率（AAMRs）。通过Joinpoint回归（Joinpoint regression Program V 5.2.0）确定95%置信区间（CI）的年百分比变化（APC）。结果：从1999年到2020年，美国共有15512例与儿科中风相关的死亡报告。AAMR总体下降，从1999年的1.26下降到2020年的1.02。男性的AAMR（1.28）高于女性（1.03）。从各地区来看，中西部地区的AAMR最高（1.24），其次是南部（1.23）、西部（1.17）、东北部（0.95）。非西班牙裔（NH）黑人或非裔美国人的AAMR最高（1.97），其次是西班牙裔或拉丁裔（1.08），NH白人（1.00），NH亚裔或太平洋岛民的AAMR最低（0.94）。每10万人的CMR在1岁年龄组中最高（CMR: 8.14），而5-14岁年龄组的粗率最低（CMR: 0.56）。城市化过程中，大城市中心区AAMR最高（1.23），大城市边缘区最低（1.02）。aamr最高的州是阿拉斯加州（1.79）、南达科他州（1.77）和哥伦比亚特区（1.75）。结论：从2012年起，死亡率呈上升趋势，男性、婴儿和非裔美国儿童是高危人群。需要采取多方面的方法，侧重于预防、早期识别和优化管理，以降低小儿卒中相关死亡率。

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

Journal of Clinical Neuroscience 医学-临床神经学

CiteScore

4.50

自引率

0.00%

发文量

402

审稿时长

40 days

期刊介绍： This International journal, Journal of Clinical Neuroscience, publishes articles on clinical neurosurgery and neurology and the related neurosciences such as neuro-pathology, neuro-radiology, neuro-ophthalmology and neuro-physiology. The journal has a broad International perspective, and emphasises the advances occurring in Asia, the Pacific Rim region, Europe and North America. The Journal acts as a focus for publication of major clinical and laboratory research, as well as publishing solicited manuscripts on specific subjects from experts, case reports and other information of interest to clinicians working in the clinical neurosciences.