Department of Pediatrics, Division of Children's and Women's Health, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
Department of Pediatrics, Västerviks Sjukhus, Västervik, Sweden.
Acta Paediatr. 2021 Jul;110(7):2179-2186. doi: 10.1111/apa.15791. Epub 2021 Feb 14.
The Swedish National Patient Register offers unique opportunities for epidemiological research of paediatric ischaemic stroke. We aimed to validate the diagnosis of paediatric ischaemic stroke in the National Patient Register to ensure the quality of future research.
The PedStroke cohort consists of 1606 individuals aged <18 years with a diagnosis of paediatric ischaemic stroke (ICD-10: I63, I64; ICD-8 and 9: 433, 434, 436) in Swedish national health registers between 1969 and 2016. We selected 292 cases for validation by reviewing medical charts.
In all, 277 of the 292 medical charts were received, of which 273 had enough information to qualify for review. The diagnosis was correct in 242/273 cases, yielding a positive predictive value (PPV) of 89% (95% confidence interval (CI): 0.85-0.92) for paediatric ischaemic stroke in the National Patient Register. After validation, seven cases of 222 with childhood stroke were re-categorised to perinatal stroke, resulting in a total of 56 perinatal stroke cases. In the Medical Birth Register, 38 stroke cases were identified of which 37 had correct diagnosis, generating a PPV of 97% (95% CI: 0.92-1.0). Incorrect diagnoses decreased over time and the number of diagnoses confirmed by radiology increased correspondingly.
The National Patient Register is reliable for epidemiological research of paediatric ischaemic stroke because of its high PPV for this diagnosis.
瑞典国家患者登记处为儿科缺血性卒中的流行病学研究提供了独特的机会。我们旨在验证国家患者登记处中儿科缺血性卒中的诊断，以确保未来研究的质量。
PedStroke 队列包括在 1969 年至 2016 年期间瑞典国家卫生登记处诊断为儿科缺血性卒中（ICD-10：I63、I64；ICD-8 和 9：433、434、436）的 1606 名年龄<18 岁的个体。我们通过审查病历选择了 292 例进行验证。
总共收到了 292 份病历中的 277 份，其中 273 份有足够的信息进行审查。273 例中有 242 例诊断正确，国家患者登记处的阳性预测值（PPV）为 89%（95%置信区间（CI）：0.85-0.92）。验证后，222 例儿童卒中病例中有 7 例重新归类为围产期卒中，总共有 56 例围产期卒中病例。在医学出生登记处，确定了 38 例卒中病例，其中 37 例诊断正确，PPV 为 97%（95%CI：0.92-1.0）。不正确的诊断随着时间的推移而减少，并且放射学确诊的诊断数量相应增加。
由于国家患者登记处对儿科缺血性卒中的诊断具有较高的阳性预测值，因此它是进行儿科缺血性卒中流行病学研究的可靠工具。
