Deakin Health Economics, Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, VIC, Australia.
Deakin Biostatistics Unit, Faculty of Health, Deakin University, Geelong, VIC, Australia.
Int J Stroke. 2023 Aug;18(7):765-772. doi: 10.1177/17474930231155336. Epub 2023 Feb 7.
Despite its importance in being among the top 10 causes of childhood death, there is limited data on the incidence of stroke in children and whether this has changed over time.
We performed a systematic review and meta-analysis to estimate the worldwide incidence rate of pediatric ischemic stroke, identify population differences, and assess trends in incidence.
We screened three databases (Medline, Embase, and Cumulative Index of Nursing and Allied Health Literature (CINAHL)) and a Google Search was performed up to October 2021. The protocol was pre-registered: PROSPERO: CRD42021273749. Data extraction and quality assessment were independently undertaken by two reviewers. A random-effects model was used for meta-analysis using Stata SE17 to calculate the overall incidence rate. Heterogeneity was assessed using I. Meta-regression and assessment for bias were performed.
Out of 4166 records identified, 39 studies were included in the qualitative synthesis and the quantitative meta-analysis. The incidence rate for all ischemic strokes varied from 0.9 to 7.9 per 100,000 person-years, with a pooled incidence of 2.09 (95% confidence interval (CI): 1.57-2.76). The pooled incidence was 1.28 (95% CI: 0.75-2.19) per 100,000 person-years for arterial ischemic stroke, and 0.56 (95% CI: 0.31-1.02) per 100,000 person-years for cerebral venous sinus thrombosis. The incidence of arterial ischemic stroke was high in neonates, less than 28 days old (18.51, 95% CI: 12.70-26.97). Significant heterogeneity was observed in the initial analyses of stroke incidence estimates, and geographical region, cohort age upper limit, length of study, study quality, and study design could not explain this. The incidence rate of childhood stroke appeared remained relatively stable over time.
Our review provides estimates of global stroke incidence, including stroke subtypes, in children. It demonstrates a particularly high stroke incidence in neonates.
尽管中风是导致儿童死亡的十大原因之一，但关于儿童中风的发病率数据有限，而且发病率是否随时间变化也不清楚。
我们进行了系统回顾和荟萃分析，以估计全世界儿童缺血性中风的发病率，确定人群差异，并评估发病率趋势。
我们筛选了三个数据库（Medline、Embase 和 Cumulative Index of Nursing and Allied Health Literature (CINAHL)），并于 2021 年 10 月进行了 Google 搜索。该方案已预先注册：PROSPERO：CRD42021273749。数据提取和质量评估由两名审查员独立进行。使用 Stata SE17 中的随机效应模型进行荟萃分析，以计算总体发病率。使用 I 评估异质性。进行了 meta 回归和偏差评估。
在 4166 条记录中，有 39 项研究被纳入定性综合和定量荟萃分析。所有缺血性中风的发病率从每 100000 人年 0.9 至 7.9 不等，汇总发病率为 2.09（95%置信区间（CI）：1.57-2.76）。动脉性缺血性中风的汇总发病率为每 100000 人年 1.28（95%CI：0.75-2.19），脑静脉窦血栓形成的发病率为每 100000 人年 0.56（95%CI：0.31-1.02）。小于 28 天的新生儿中动脉性缺血性中风的发病率较高（18.51，95%CI：12.70-26.97）。在对中风发病率估计的初始分析中观察到显著的异质性，而地理区域、队列年龄上限、研究长度、研究质量和研究设计均无法解释这一点。儿童中风的发病率似乎随着时间的推移保持相对稳定。
我们的综述提供了全球儿童中风发病率的估计，包括中风亚型。它表明新生儿中风发病率特别高。
