title: Contribution of Sickle Cell Disease to the Pediatric Stroke Burden Among Hospital Discharges of African-Americans-United States, 1997-2012.
abstract: BACKGROUND
  Approximately 10-20% of children with sickle cell disease (SCD) develop stroke, but few consistent national estimates of the stroke burden for children with SCD exist. The purpose of this study is to determine the proportion of diagnosed stroke among African-American pediatric discharges with and without SCD.
  
  
  METHODS
  Records for African-Americans aged 1-18 years in the Kids' Inpatient Database (KID) 1997-2012 with ≥1 ICD-9-CM diagnosis code for stroke were included. Data were weighted to provide national estimates. A total of 2,994 stroke cases among African-American children were identified. Diagnoses co-existing with ischemic or hemorrhagic stroke were frequency ranked separately.
  
  
  RESULTS
  From 1997 through 2012, SCD was present in 24% of stroke discharges, with 89% being ischemic stroke. For hospital discharges of African-American children, SCD is the highest co-existing risk factor for ischemic stroke (29%). Stroke in children with SCD occurred predominantly in children aged 5-9 years, older than previously reported. The trend of stroke discharges significantly decreased for children with SCD from 1997 to 2012 for children aged 10-14 years.
  
  
  CONCLUSIONS
  SCD is a leading risk factor to pediatric stroke in African-American children. Reducing the number of strokes among children with SCD would have a significant impact on the rate of strokes among African-American children. Preventative intervention may be modifying initial age of presentation of stroke in children with SCD.
authors.affiliation: Division of Blood Disorders, National Center for Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Baker
authors.affiliation: Division of Blood Disorders, National Center for Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Althea M
authors.initials: AM
authors.lastname: Grant
authors.affiliation: Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Mary G
authors.initials: MG
authors.lastname: George
authors.affiliation: Division of Blood Disorders, National Center for Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Scott D
authors.initials: SD
authors.lastname: Grosse
authors.affiliation: Department of Family Medicine, Morehouse School of Medicine, Atlanta, Georgia.
authors.forename: Thomas V
authors.initials: TV
authors.lastname: Adamkiewicz
mesh_terms: D000293:Adolescent; D001741:Black or African American; D000755:Anemia, Sickle Cell / Q000150:complications / Q000453:epidemiology* / Q000628:therapy; D002545:Brain Ischemia / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010351:Patient Discharge; D012189:Retrospective Studies; D020521:Stroke / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy; D014481:United States / Q000453:epidemiology
keywords: hemorrhagic stroke; hospitalization; ischemic stroke; sickle cell disease