Bindslev Julie Brix, Valentin Jan Brink, Johnsen Søren P, Hauerberg John, Hansen Klaus, Hoei-Hansen Christina Engel, Truelsen Thomas
Department of Neurology, University Hospital of Copenhagen, Rigshospitalet, Denmark.
Department of Pediatrics, University Hospital of Copenhagen, Rigshospitalet, Denmark.
Neurology. 2025 Aug 12;105(3):e213901. doi: 10.1212/WNL.0000000000213901. Epub 2025 Jul 17.
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.
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.
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.
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.
本研究旨在评估2013年至2020年丹麦儿童卒中的发病率、发病率变化及预后情况。
通过全国性登记系统，我们确定了2013年至2020年间首次登记患有卒中或卒中相关诊断的所有儿童（年龄29天至17岁）。可能的卒中事件通过病历审查进行验证。采用泊松回归分析估计年龄调整后的发病率及发病率的绝对变化。采用Kaplan-Meier分析估计30天、1年和5年的累积死亡风险。
2013年至2020年间，男性年龄调整后的卒中发病率上升，而女性未发现变化。男性中观察到的趋势是由动脉缺血性卒中（AIS）发病率增加所致（每10万人年的年度绝对变化：0.14，95%CI 0.018 - 0.26）。30天、1年和5年的累积死亡风险分别为7.7%（95%CI 4.2 - 11.2）、10.0%（95%CI 6.0 - 13.9）和11.0%（95%CI 6.8 - 15.2）。死亡风险随时间保持稳定（ 值 = 0.77）。在随访时存活的儿童中，AIS患儿有20.2%存在中度至重度神经功能缺损，脑出血患儿有23.1%存在中度至重度神经功能缺损。
2013年至2020年，儿童卒中的年龄调整发病率在男性中上升，而在女性中保持稳定。卒中后的发病率和死亡率很高，凸显了进一步改善儿童卒中管理的必要性。
