Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria.
Comprehensive Centre for Pediatrics, Medical University of Vienna, Vienna, Austria.
Dev Med Child Neurol. 2021 Apr;63(4):465-471. doi: 10.1111/dmcn.14779. Epub 2020 Dec 18.
To determine whether socioeconomic status (SES) is a stronger predictor for cognitive outcome after childhood arterial ischemic stroke compared to clinical factors.
We investigated perceptual reasoning, executive functions, language, memory, and attention in 18 children and adolescents (12 males, six females, median age at testing 13y 4mo, range 7y-17y 5mo) after arterial ischemic stroke; collected sociodemographic information (education of parents, household income); and used clinical information (initial lesion volume, residual lesion volume, age at stroke, time since stroke). Linear regression models were used to investigate the potential influence of SES and clinical parameters on cognitive abilities.
SES had a moderate effect on all cognitive outcome parameters except attention by explaining 41.9%, 37.9%, 38.0%, and 22.5% of variability in perceptual reasoning, executive functions, language, and memory respectively. Initial lesion volume was the only clinical parameter that showed moderate importance on cognitive outcome (33.1% and 25.6% of the variability in perceptual reasoning and memory respectively). Overall, SES was a stronger predictor of cognitive outcome than clinical factors.
Future paediatric studies aiming at clinical predictors of cognitive outcome should control their analyses for SES in their study participants. The findings of the present study further point to the need for more attention to the treatment of children with low SES.
Socioeconomic status (SES) explains up to 42% of variance in cognitive outcome after childhood arterial ischemic stroke. SES is a stronger predictor of outcome than clinical factors.
确定社会经济地位（SES）是否比临床因素更能预测儿童后天性脑动脉缺血性卒中后的认知结局。
我们对 18 名（12 名男性，6 名女性）儿童和青少年（中位发病年龄为 13 岁 4 个月，范围为 7 岁 5 个月至 17 岁 5 个月）的动脉缺血性卒中后进行了知觉推理、执行功能、语言、记忆和注意力等认知能力的测试；收集了社会人口统计学信息（父母的教育程度、家庭收入）；并使用了临床信息（初始病灶体积、残留病灶体积、发病年龄、发病至测试时间）。采用线性回归模型来探讨 SES 和临床参数对认知能力的潜在影响。
SES 对除注意力以外的所有认知结局参数均有中度影响，分别解释了知觉推理、执行功能、语言和记忆的变异性的 41.9%、37.9%、38.0%和 22.5%。初始病灶体积是唯一对认知结局有中度重要性的临床参数（分别解释了知觉推理和记忆变异性的 33.1%和 25.6%）。总体而言，SES 是认知结局的一个比临床因素更强的预测因素。
未来旨在研究认知结局的临床预测因素的儿科研究应在其研究参与者的分析中控制 SES。本研究的结果进一步表明，需要更多地关注 SES 较低的儿童的治疗。
社会经济地位（SES）解释了儿童后天性脑动脉缺血性卒中后认知结局的 42%的变异性。SES 是结局的一个比临床因素更强的预测因素。
