Volume 21 Issue 2
Feb.  2023
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Article Navigation >  Chinese Journal of General Practice  > 2023  >  21(2): 180-185
ZHOU Ji-hua, MING Mei-xiu, CHEN Wei-ming, LU Guo-ping. Characteristics and functional outcome of childhood stroke in a pediatric intensive care unit[J]. Chinese Journal of General Practice, 2023, 21(2): 180-185. doi: 10.16766/j.cnki.issn.1674-4152.002840
Citation: ZHOU Ji-hua, MING Mei-xiu, CHEN Wei-ming, LU Guo-ping. Characteristics and functional outcome of childhood stroke in a pediatric intensive care unit[J]. Chinese Journal of General Practice, 2023, 21(2): 180-185. doi: 10.16766/j.cnki.issn.1674-4152.002840
shu

Characteristics and functional outcome of childhood stroke in a pediatric intensive care unit

doi: 10.16766/j.cnki.issn.1674-4152.002840

  • Department of Critical Care Medicine, Children ' s Hospital of Fudan University, Shanghai 201102, China

Funds:

 2021YFC2701800

 2021YFC2701805

  • Received Date: 2022-12-09
    Available Online: 2023-04-20
    Abstract
  •   Objective  To explore the clinical characteristics of children with stroke in a pediatric intensive care unit (PICU) and analyze the risk factors of its functional outcome.  Methods  A total of 163 consecutive childhood stroke patients admitted in PICU of the Affiliated Pediatric Hospital of Fudan University from July 2018 to June 2022 were included. The score of the brain function classification scale at hospital discharge (ranging from 1 to 6 points) ≥ 4 points was regarded as poor functional outcome. Patients characteristics were collected, and multivariate logistic regression analyses were performed to screen risk factors of poor functional outcome at hospital discharge and in-hospital mortality.  Results  Among 163 patients, 88 cases were male patients (54.0%), with an onset age of 4.5 (1.2, 9.3) years. There were 84 cases of ischemic stroke (IS) and 79 cases of hemorrhagic stroke (HS). The overall case-fatality was 16.6% at hospital discharge, and the mortality rates of IS and HS were 8.3% (7/84) and 25.3% (20/79) respectively. There were 55 patients (33.7%) with poor functional outcomes at hospital discharge. Among 136 cases surviving to hospital discharge, 95 cases (69.9%) had residual disability. Lower modified Glasgow Coma Scale (GCS) score on PICU admission was significantly associated with poor functional outcome at hospital discharge (OR=0.658, 95% CI: 0.582-0.743, P < 0.001). HS (OR=3.071, 95% CI: 1.121-8.417, P=0.029) and lower modified GCS score on PICU admission (OR=0.738, 95% CI: 0.648-0.840, P < 0.001) were significantly associated with in-hospital mortality.  Conclusion  Among patients with childhood stroke hospitalized in PICU, IS and HS account for about half of childhood stroke each. One-third cases have poor functional outcome at hospital discharge, however, of those survivors, over two-thirds cases have residual disability. Lower modified GCS on PICU admission is a risk factor of poor functional outcome at hospital discharge and it could be used as a clinical early warning parameter for risk probability prediction. HS and lower modified GCS on PICU admission are risk factors of in-hospital mortality.

     

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