Document Detail


National trends in incidence rates of hospitalization for stroke in children with sickle cell disease.
MedLine Citation:
PMID:  23151905     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The success of primary stroke prevention for children with sickle cell disease (SCD) throughout the United States is unknown. Therefore, we aimed to generate national incidence rates of hospitalization for stroke in children with sickle cell disease (SCD) before and after publication of the Stroke Prevention Trial in Sickle Cell Anemia (STOP trial) in 1998.
PROCEDURE: We performed a retrospective trend analysis of the 1993-2009 Nationwide Inpatient Sample and Kids' Inpatient Databases. Hospitalizations for SCD patients 0-18 years old with stroke were identified by ICD-9CM code. The primary outcome, the trend in annual incidence rate of hospitalization for stroke in children with SCD, was analyzed by linear regression. Incidence rates of hospitalization for stroke before and after 1998 were compared by the Wilcoxon rank-sum test.
RESULTS: From 1993 to 2009, 2,024 hospitalizations were identified for stroke. Using the mean annual incidence rate of hospitalization for stroke from 1993 to 1998 as the baseline, the rate decreased from 1993 to 2009 (point estimate = -0.022/100 patient years [95% CI, -0.039, -0.005], P = 0.027). The mean annual incidence rate of hospitalization stroke decreased by 45% from 0.51 per 100 patient years in 1993-1998 to 0.28 per 100 patient years in 1999-2009 (P = 0.008). Total hospital days and charges attributed to stroke also decreased by 45% and 24%, respectively.
CONCLUSIONS: After publication of the STOP trial and hydroxyurea licensure in 1998, the incidence of hospitalization for stroke in children with SCD decreased across the United States, suggesting that primary stroke prevention has been effective nationwide, but opportunity for improvement remains.
Authors:
Timothy L McCavit; Lei Xuan; Song Zhang; Glenn Flores; Charles T Quinn
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2012-11-14
Journal Detail:
Title:  Pediatric blood & cancer     Volume:  60     ISSN:  1545-5017     ISO Abbreviation:  Pediatr Blood Cancer     Publication Date:  2013 May 
Date Detail:
Created Date:  2013-03-15     Completed Date:  2013-05-21     Revised Date:  2014-08-06    
Medline Journal Info:
Nlm Unique ID:  101186624     Medline TA:  Pediatr Blood Cancer     Country:  United States    
Other Details:
Languages:  eng     Pagination:  823-7     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Wiley Periodicals, Inc.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Anemia, Sickle Cell / complications,  epidemiology*
Child
Child, Preschool
Databases, Factual
Female
Hospitalization / statistics & numerical data*,  trends
Humans
Incidence
Male
Retrospective Studies
Risk Factors
Stroke / epidemiology*,  etiology,  prevention & control
United States / epidemiology
Grant Support
ID/Acronym/Agency:
U54 HL0705088-06/HL/NHLBI NIH HHS; UL1 RR024982-03/RR/NCRR NIH HHS; UL1 TR000077/TR/NCATS NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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