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Predicting Recovery and Outcome after Pediatric Stroke: Results from the International Pediatric Stroke Study.

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dc.contributor.authorFelling, Ryan J
dc.contributor.authorRafay, Mubeen F
dc.contributor.authorBernard, Timothy J
dc.contributor.authorCarpenter, Jessica L
dc.contributor.authorDlamini, Nomazulu
dc.contributor.authorHassanein, Sahar M A
dc.contributor.authorJordan, Lori C
dc.contributor.authorNoetzel, Michael J
dc.contributor.authorRivkin, Michael J
dc.contributor.authorShapiro, Kevin A
dc.contributor.authorSlim, Mahmoud
dc.contributor.authordeVeber, Gabrielle
dc.date.accessioned2024-10-05T12:03:43Z
dc.date.available2024-10-05T12:03:43Z
dc.date.issued2020-06
dc.description.abstractOBJECTIVE To characterize predictors of recovery and outcome following pediatric arterial ischemic stroke, hypothesizing that age influences recovery after stroke. METHODS We studied children enrolled in the International Pediatric Stroke Study between January 1, 2003 and July 31, 2014 with 2-year follow-up after arterial ischemic stroke. Outcomes were defined at discharge by clinician grading and at 2 years by the Pediatric Stroke Outcome Measure. Demographic, clinical, and radiologic outcome predictors were examined. We defined changes in outcome from discharge to 2 years as recovery (improved outcome), emerging deficit (worse outcome), or no change. RESULTS Our population consisted of 587 patients, including 174 with neonatal stroke and 413 with childhood stroke, with recurrent stroke in 8.2% of childhood patients. Moderate to severe neurological impairment was present in 9.4% of neonates versus 48.8% of children at discharge compared to 8.0% versus 24.7% after 2 years. Predictors of poor outcome included age between 28 days and 1 year (compared to neonates, odds ratio [OR] = 3.58, p < 0.05), underlying chronic disorder (OR = 2.23, p < 0.05), and involvement of both small and large vascular territories (OR = 2.84, p < 0.05). Recovery patterns differed, with emerging deficits more common in children <1 year of age (p < 0.05). INTERPRETATION Outcomes after pediatric stroke are generally favorable, but moderate to severe neurological impairments are still common. Age between 28 days and 1 year appears to be a particularly vulnerable period. Understanding the timing and predictors of recovery will allow us to better counsel families and target therapies to improve outcomes after pediatric stroke. ANN NEUROL 2020;87:840-852.
dc.description.noteInternational Pediatric Stroke Study Group: Prof Dr. Steinlin
dc.description.numberOfPages13
dc.identifier.doi10.48350/151401
dc.identifier.pmid32215969
dc.identifier.publisherDOI10.1002/ana.25718
dc.identifier.urihttps://boris-portal.unibe.ch/handle/20.500.12422/56060
dc.language.isoen
dc.publisherWiley-Blackwell
dc.relation.ispartofAnnals of neurology
dc.relation.issn1531-8249
dc.relation.organizationDCD5A442BADAE17DE0405C82790C4DE2
dc.relation.organizationDCD5A442BB6FE17DE0405C82790C4DE2
dc.subject.ddc600 - Technology::610 - Medicine & health
dc.titlePredicting Recovery and Outcome after Pediatric Stroke: Results from the International Pediatric Stroke Study.
dc.typearticle
dspace.entity.typePublication
dspace.file.typetext
oaire.citation.endPage852
oaire.citation.issue6
oaire.citation.startPage840
oaire.citation.volume87
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unibe.date.licenseChanged2021-01-19 08:06:55
unibe.description.ispublishedpub
unibe.eprints.legacyId151401
unibe.journal.abbrevTitleANN NEUROL
unibe.refereedTRUE
unibe.subtype.articlejournal

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