Abstract P586: Care and Outcomes of Pediatric Community vs. In-Hospital Stroke
| Autor: | Dana D Cummings, Elissa Ortolani |
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| Rok vydání: | 2021 |
| Předmět: | |
| Zdroj: | Stroke. 52 |
| ISSN: | 1524-4628 0039-2499 |
| DOI: | 10.1161/str.52.suppl_1.p586 |
| Popis: | Introduction: In-hospital stroke refers to stroke occurring during an acute care hospitalization. Unlike stroke occurring in the community, there is a potential for rapid diagnosis and treatment given access to resources. Existing research in adults however suggest higher rates of morbidity and mortality compared to community onset stroke patients. Worse outcomes may be multifactorial, including risk factors inherent to the inpatient status and relative contraindication for acute therapy . However, little is known of the care and outcomes of in hospital stroke in pediatric patients. Objectives: Our goal was to evaluate the stroke care and outcome of pediatric patients with in-hospital and community onset stroke. Our primary outcome was the time from stroke symptoms to the first neuroimaging procedure( less than 4.5 hours, 4.5 to 12 hours, 12 hours to 24 hours or greater than 24 hours). Secondary outcomes include type neuroimaging preformed, stroke risk factors, clinical stroke presentation, length of stay, and discharge destination. Methods: Retrospective chart review of children > 28 days and less than or equal to 18 years with diagnosis of acute stroke by clinical and radiographic criteria admitted between January 2009 and September 2019. Results: We screened a total of 779 patients, and identified 63 patients with in hospital strokes and 109 patients with community strokes. The largest percentage of in-hospital strokes had imaging obtained between 4.5 to 12 hours from last known well vs. over 24 hours in the community stroke group. CT was the most common imaging obtained in both groups. The major stroke risk factor was cardiac disease in the in-hospital stroke group versus infection in the community group. Clinical presentation was more common to be focal in the community group, versus non-focal in the in-hospital group. Length of stay was longer in the in-hospital stroke group and discharge destination was more commonly rehab in the in-hospital group vs. home in the community group .Mortality was higher in the in-hospital population. Conclusion: Patients with in-hospital stroke have more rapid diagnosis, but have increase rates of mortality . Presentations in this group are more commonly non-focal, and the largest stroke risk factor is cardiac disease. |
| Databáze: | OpenAIRE |
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