title: 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.
authors.affiliation: Department of Neurology, Children's National Medical Center, Washington, D.C.
authors.forename: J J
authors.initials: JJ
authors.lastname: Higgins
authors.forename: L A
authors.initials: LA
authors.lastname: Kammerman
authors.forename: C R
authors.initials: CR
authors.lastname: Fitz
mesh_terms: D002561:Cerebrovascular Disorders / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000401:mortality; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011336:Probability; D012189:Retrospective Studies; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed