Predictors of Survival and Characteristics of Childhood Stroke*

Abstract

To determine predictors of outcome we reviewed 226 medical records of patients admitted to Children's National Medical Center with the diagnosis of cerebrovascular disease from 1978 to 1988. Ninety-five cases of stroke were identified by either neuroimaging techniques (87), autopsy (7), or clinical examination (1). Causal factors implicated in 89 % of the patients included infectious (21 %), vascular (18 %), hematologic (15 %), cardiac (13 %) problems, minor trauma (8%) or miscellaneous (14%) causes. Patient outcome (n = 88) included residual impairment in 54 %, complete resolution of their initial deficit in 23 %, and death in 23 %.

Among patients with abnormal CT findings (n = 60), a logistic regression model revealed that patients with hemorrhage were at a significant risk (p = 0.0469) for death (odds ratio (OR) = 5.5, 95 % confidence interval (CI) 1.2-24.5); those with an altered level of consciousness (stupor or coma) on presentation were also at risk (p = 0.0166; OR = 6.94, CI 1.7-28.5). The sensitivity and specificity of this model were 57 % and 93 %, respectively. No other clinical, laboratory, or demographic variable analyzed was predictive of outcome.

Childhood stroke - Survival - Characteristics