One approach to studying pediatric stroke is to analyze a national database that contains data on a significant number of children. We examined an administrative dataset of hospital discharges from the United States, Kids' Inpatient Database 2003 (KID2003), for ICD-9 codes associated with hemorrhagic or ischemic stroke in children aged >30 days to 20 years. 3156 children were discharged with a diagnosis of ischemic stroke and 2022 with hemorrhagic stroke after statistical weighting. The odds for a male discharged with hemorrhagic stroke was 1.5 (CI: 1.35-1.68) and for ischemic stroke was 1.37 (CI: 1.24-1.51) compared with a female. The odds for males discharged with a stroke were greatest for ages 16 to 20 years and least for 4 years. This study confirms a male predominance for stroke. The odds for hospitalization with a stroke diagnosis are greatest in very young and older adolescent males. Hemorrhage is an important stroke subtype in children.
Nowak-Gottl U., Gunther G., Kurnik K., Strater R., Kirkham F.Arterial ischemic stroke in neonates, infants, and children: an overview of underlying conditions, imaging methods, and treatment modalities. Semin Thromb Hemost.2003;29:405-414.
2.
Lynch JK, Han CJ, Nee LE, Nelson KBProthrombotic factors in children with stroke or porencephaly. Pediatrics. 2005;116: 447-453.
3.
Kuhle S., Mitchell L., Andrew M., et al. Urgent clinical challenges in children with ischemic stroke: analysis of 1065 patients from the 1-800-NOCLOTS pediatric stroke telephone consultation service. Stroke. 2006;37:116-122.
4.
Broderick J. , Talbot GT, Prenger E., Leach A., Brott T.Stroke in children within a major metropolitan area: the surprising importance of intracerebral hemorrhage. J Child Neurol. 1993;8:250-255.
5.
Schoenberg BS , Mellinger JF, Schoenberg DGCerebrovascular disease in infants and children: a study of incidence, clinical features, and survival. Neurology . 1978;28:763-768.
6.
Giroud M., Lemesle M., Gouyon JB, Nivelon JL, Milan C., Dumas R.Cerebrovascular disease in children under 16 years of age in the city of Dijon, France: a study of incidence and clinical features from 1985 to 1993. J Clin Epidemiol.1995;48: 1343-1348.
7.
Chung B., Wong V.Pediatric stroke among Hong Kong Chinese subjects. Pediatrics . 2004;114:e206-e212.
8.
Fullerton HJ , Wu YW, Zhao S., Johnston SCRisk of stroke in children: ethnic and gender disparities. Neurology. 2003;61: 189-194.
9.
Steinlin M., Pfister I., Pavlovic J., et al. The first three years of the Swiss Neuropaediatric Stroke Registry (SNPSR): a population-based study of incidence, symptoms and risk factors . Neuropediatrics. 2005;36:90-97.
10.
deVeber G., Andrew M.Cerebral sinovenous thrombosis in children. N Engl J Med. 2001;345:417-423.
11.
Fullerton HJ , Chetkovich DM, Wu YW, Smith WS, Johnston SCDeaths from stroke in US children, 1979 to 1998. Neurology. 2002;59:34-39.
12.
Fullerton HJ , Elkins JS, Johnston SCPediatric Stroke Belt: geographic variation in stroke mortality in US children. Stroke. 2004;35:1570-1573.
13.
Chen PC, Chien KL, Chang CW, et al. More hemorrhagic and severe events cause higher hospitalization care cost for childhood stroke in Taiwan. J Pediatr. 2008;152:388-393.
14.
Healthcare Cost and Utilization Project (HCUP).Kids' Inpatient Database (KID2003). Rockville, MD: Agency for Healthcare Research and Quality; 2005.
15.
Feinberg EC, Larsen FW, Catherino WH, Zhang J., Armstrong AYComparison of assisted reproductive technology utilization and outcomes between Caucasian and African American patients in an equal-access-to-care setting . Fertil Steril. 2006;85:888-894.
16.
Tirschwell DL , Longstreth WT, Jr.Validating administrative data in stroke research. Stroke. 2002;33:2465-2470.
17.
Estimates of the July 1, 2000-July 1, 2003, United States resident population from the Vintage 2003 postcensal series by year, county, age, sex, race, and Hispanic origin, prepared under a collaborative arrangement with the U.S. Census Bureau. National Center for Health Statistics. 9-14-2004.
18.
deVeber GA, MacGregor D., Curtis R., Mayank S.Neurologic outcome in survivors of childhood arterial ischemic stroke and sinovenous thrombosis. J Child Neurol.2000 ;15:316-324.
19.
Williams LS , Garg BP, Cohen M., Fleck JD, Biller J.Subtypes of ischemic stroke in children and young adults. Neurology. 1997;49:1541-1545.
20.
Salih MA, Abdel-Gader AG, Al-Jarallah AA, et al. Stroke in Saudi children. Epidemiology, clinical features and risk factors. Saudi Med J. 2006;27 (suppl 1):S12-S20.
21.
Golomb MR, Fullerton HJ, deVeber G.Childhood ischemic stroke is more common in boys: findings from the International Paediatric Stroke Study. Stroke. 2008;39:546.
22.
deVeber G., Monagle P., Chan A., et al. Prothrombotic disorders in infants and children with cerebral thromboembolism. Arch Neurol.1998;55:1539-1543.
23.
Chabrier S. , Husson B., Lasjaunias P., Landrieu P., Tardieu M.Stroke in childhood: outcome and recurrence risk by mechanism in 59 patients. J Child Neurol. 2000;15:290-294.
24.
Kirkham FJ, Prengler M., Hewes DK, Ganesan V.Risk factors for arterial ischemic stroke in children. J Child Neurol. 2000;15:299-307.
25.
Ganesan V., Prengler M., McShane MA, Wade AM, Kirkham FJInvestigation of risk factors in children with arterial ischemic stroke. Ann Neurol. 2003;53:167-173.
26.
Hansen ML, Gunn PW, Kaelber DCUnderdiagnosis of hypertension in children and adolescents. JAMA. 2007;298:874-879.
27.
Park MKThe Pediatric Cardiology Handbook. 3rd ed. St. Louis, MO: Mosby; 2003.
Miravet E., Danchaivijitr N., Basu H., Saunders DE, Ganesan V.Clinical and radiological features of childhood cerebral infarction following varicella zoster virus infection. Dev Med Child Neurol. 2007;49:417-422.
31.
Sebire G., Meyer L., Chabrier S.Varicella as a risk factor for cerebral infarction in childhood: a case-control study. Ann Neurol. 1999;45:679-680.
32.
Askalan R., Laughlin S., Mayank S., et al. Chickenpox and stroke in childhood: a study of frequency and causation. Stroke. 2001;32:1257-1262.
33.
Lynch JKThe hospitalization of childhood stroke in the United States, 1979-2000. Stroke. 2003;34:51.
34.
Brown P., Guy M., Broad J.Individual socio-economic status, community socio-economic status and stroke in New Zealand: a case control study. Soc Sci Med. 2005;61:1174-1188.
35.
Bravata DM, Wells CK, Gulanski B., et al. Racial disparities in stroke risk factors: the impact of socioeconomic status. Stroke. 2005;36:1507-1511.
36.
Cox AM, McKevitt C., Rudd AG, Wolfe CDSocioeconomic status and stroke. Lancet. Neurol.2006;5:181-188.
37.
Avendano M. , Kawachi I., Van LF, et al. Socioeconomic status and stroke incidence in the US elderly: the role of risk factors in the EPESE study. Stroke. 2006;37:1368-1373.
38.
Kleindorfer DO, Lindsell C., Broderick J., et al. Impact of socioeconomic status on stroke incidence: a population-based study. Ann Neurol. 2006;60:480-484.
39.
Kuper H., Adami HO, Theorell T., Weiderpass E.The socioeconomic gradient in the incidence of stroke: a prospective study in middle-aged women in Sweden. Stroke. 2007 ;38:27-33.
40.
Benesch C., Witter DM, Jr., Wilder AL, Duncan PW, Samsa GP, Matchar DBInaccuracy of the International Classification of Diseases (ICD-9-CM) in identifying the diagnosis of ischemic cerebrovascular disease. Neurology . 1997;49:660-664.
41.
Goldstein LBAccuracy of ICD-9-CM coding for the identification of patients with acute ischemic stroke: effect of modifier codes. Stroke. 1998;29:1602-1604.
42.
Golomb MR, Garg BP, Saha C., Williams LSAccuracy and yield of ICD-9 codes for identifying children with ischemic stroke . Neurology. 2006;67:2053-2055.
43.
Golomb MR, Garg BP, Williams LSAccuracy of ICD-9 codes for identifying children with cerebral sinovenous thrombosis. J Child Neurol. 2007;22:45-48.
