Incidence and Prognosis of Pediatric Stroke in Denmark: A Nationwide Population-Based Study.

BACKGROUND AND OBJECTIVES

The aim of this study was to estimate incidence rates, changes in incidence rates, and prognosis of pediatric stroke in Denmark from 2013 to 2020.

METHODS

Through a nationwide register, we identified all children (age 29 days-17 years) registered with a first-ever stroke or stroke-related diagnosis between 2013 and 2020. Possible stroke events were validated by medical record review. Age-adjusted incidence rates and absolute changes in incidence rates were estimated by Poisson regression analysis. Kaplan-Meier analysis was used to estimate 30-day, 1-year, and 5-year cumulative mortality risks.

RESULTS

Between 2013 and 2020, the age-adjusted stroke incidence rate increased in male individuals while no change was noted in female individuals. The trend observed in male individuals was driven by the increased incidence rate of arterial ischemic stroke (AIS) (yearly absolute change per 100,000 person-years: 0.14, 95% CI 0.018-0.26). The 30-day, 1-year, and 5-year cumulative mortality risks were 7.7% (95% CI 4.2-11.2), 10.0% (95% CI 6.0-13.9), and 11.0% (95% CI 6.8-15.2), respectively. Mortality risk remained stable over time ( value = 0.77). Among children alive at follow-up, moderate-severe neurologic impairment was present in 20.2% with AIS and 23.1% with intracerebral hemorrhage.

DISCUSSION

From 2013 through 2020, the age-adjusted incidence rate of pediatric stroke increased in male individuals while remaining stable in female individuals. Morbidity and mortality after stroke were substantial, highlighting the need for further improvements in pediatric stroke management.