title: Age at stroke onset influences the clinical outcome and health-related quality of life in pediatric ischemic stroke survivors.
abstract: OBJECTIVE
  Stroke in children occurs across different phases of brain development. Age at onset may affect outcome and health-related quality of life (HRQL). We evaluated the influence of age at stroke onset on the long-term neurological outcomes and HRQL of pediatric stroke survivors.
  
  
  METHODS
  Children with ischemic stroke were recruited into three groups according to their age at onset of stroke (presumed perinatal, neonatal, and childhood). Neurological outcomes were assessed using the Pediatric Stroke Recovery and Recurrence Questionnaire. HRQL was evaluated using proxy report versions (2-18y) of the Pediatric Quality of Life Inventory (PedsQL 4.0). A χ(2) /Fisher's exact test and multivariable logistic regression analysis was performed for the neurological outcomes. HRQL scores from the different age groups were compared using linear regression.
  
  
  RESULTS
  Ninety participants (presumed perinatal stroke, n=31; neonatal stroke, n=36; childhood stroke, n=23) were enrolled. Median age at the onset of stroke was 0.5 days and 3.7 years in neonatal and childhood participants respectively. Of the three groups, participants with presumed perinatal stroke demonstrated the worst global (p<0.002) and motor (p<0.001) outcomes and the lowest level of independence in daily activities (p<0.001). Parents reported the best global outcome and overall HRQL (p=0.007) after neonatal stroke.
  
  
  CONCLUSIONS
  The age at stroke onset has important implications regarding long-term clinical outcomes and HRQL for survivors. Individuals with presumed perinatal stroke should be considered at high-risk for poor outcomes.
authors: Department of Pediatrics, University of Alberta, Edmonton, AL, Canada.
authors: Satvinder K
authors: SK
authors: Ghotra
authors: Faculty of Public Health Sciences, University of Alberta, Edmonton, AL, Canada.
authors: Jeffrey A
authors: JA
authors: Johnson
authors: Faculty of Public Health Sciences, University of Alberta, Edmonton, AL, Canada.
authors: Weiyu
authors: W
authors: Qiu
authors: Department of Pediatrics, University of Alberta, Edmonton, AL, Canada.
authors: Amanda
authors: A
authors: Newton
authors: Department of Pediatrics, University of Alberta, Edmonton, AL, Canada.
authors: Carmen
authors: C
authors: Rasmussen
authors: Department of Pediatrics, University of Alberta, Edmonton, AL, Canada.
authors: Jerome Y
authors: JY
authors: Yager
mesh_terms: D000293:Adolescent; D000367:Age Factors; D017668:Age of Onset; D002545:Brain Ischemia / Q000150:complications; D002648:Child; D002675:Child, Preschool; D005260:Female; D006304:Health Status; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009460:Neurologic Examination; D011788:Quality of Life / Q000523:psychology*; D020521:Stroke / Q000209:etiology / Q000401:mortality / Q000523:psychology