Clinical characteristics and quality care indicators of pediatric stroke in a referral center of Colombia: eleven-year experience (pediastroke)

ObjectiveThis study aims to describe clinical variables and quality care indicators in pediatric stroke management at a high-complexity pediatric care center in Latin America.MethodsRetrospective study of patients with stroke, aged 2–18 years from 2011 to 2021. The principal outcomes were the mRs an...

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Main Authors: Valeria Valencia-Cifuentes, Natalia Llanos-Leyton, Maria Camila Gómez-Ayala, Camila Ariza-Insignares, Julian Alejandro Rivillas, Ana María Granados-Sánchez, Juan Camilo Márquez, Laura Galvis-Blanco, Santiago Cruz-Zamorano, Juan Fernando Gómez-Castro, Rubén Eduardo Lasso, Luis Miguel Rámirez-Muñoz, Juan Manuel Castro-Varela, Paula Andrea Benavides-Llano, Pablo Amaya
Format: Article
Language:English
Published: Frontiers Media S.A. 2024-12-01
Series:Frontiers in Neurology
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Online Access:https://www.frontiersin.org/articles/10.3389/fneur.2024.1456134/full
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author Valeria Valencia-Cifuentes
Valeria Valencia-Cifuentes
Natalia Llanos-Leyton
Maria Camila Gómez-Ayala
Camila Ariza-Insignares
Camila Ariza-Insignares
Julian Alejandro Rivillas
Julian Alejandro Rivillas
Julian Alejandro Rivillas
Ana María Granados-Sánchez
Ana María Granados-Sánchez
Juan Camilo Márquez
Juan Camilo Márquez
Laura Galvis-Blanco
Laura Galvis-Blanco
Laura Galvis-Blanco
Santiago Cruz-Zamorano
Santiago Cruz-Zamorano
Santiago Cruz-Zamorano
Juan Fernando Gómez-Castro
Juan Fernando Gómez-Castro
Juan Fernando Gómez-Castro
Rubén Eduardo Lasso
Rubén Eduardo Lasso
Rubén Eduardo Lasso
Luis Miguel Rámirez-Muñoz
Juan Manuel Castro-Varela
Paula Andrea Benavides-Llano
Paula Andrea Benavides-Llano
Pablo Amaya
Pablo Amaya
author_facet Valeria Valencia-Cifuentes
Valeria Valencia-Cifuentes
Natalia Llanos-Leyton
Maria Camila Gómez-Ayala
Camila Ariza-Insignares
Camila Ariza-Insignares
Julian Alejandro Rivillas
Julian Alejandro Rivillas
Julian Alejandro Rivillas
Ana María Granados-Sánchez
Ana María Granados-Sánchez
Juan Camilo Márquez
Juan Camilo Márquez
Laura Galvis-Blanco
Laura Galvis-Blanco
Laura Galvis-Blanco
Santiago Cruz-Zamorano
Santiago Cruz-Zamorano
Santiago Cruz-Zamorano
Juan Fernando Gómez-Castro
Juan Fernando Gómez-Castro
Juan Fernando Gómez-Castro
Rubén Eduardo Lasso
Rubén Eduardo Lasso
Rubén Eduardo Lasso
Luis Miguel Rámirez-Muñoz
Juan Manuel Castro-Varela
Paula Andrea Benavides-Llano
Paula Andrea Benavides-Llano
Pablo Amaya
Pablo Amaya
author_sort Valeria Valencia-Cifuentes
collection DOAJ
description ObjectiveThis study aims to describe clinical variables and quality care indicators in pediatric stroke management at a high-complexity pediatric care center in Latin America.MethodsRetrospective study of patients with stroke, aged 2–18 years from 2011 to 2021. The principal outcomes were the mRs and mortality. Differences between groups were assessed using Fisher’s exact test and the Mann–Whitney U test. We used logistic regression to explore the association between characteristics reported as relevant in literature and mortality.ResultsOne hundred thirty six patients included, with a median age of 11 years, 54% were male. 47% were hemorrhagic strokes, followed by ischemic strokes at 39%. One-third of the cases presented in hospital. 51% of the patients had no prior medical history. The most common symptoms were altered consciousness, headache, and hemiparesis. The median door-to-image time was 123 min. The most frequent etiologies in ischemic stroke were arteriopathies and cardiac pathology, while vascular malformation and coagulopathies were predominant in hemorrhagic stroke. No patient received reperfusion therapy. At discharge, 48% of patients had a favorable mRs. The mortality rate was 21%. Patients with in-hospital stroke have approximately 7.37 times the odds of dying compared to those with out-of-hospital stroke. Patients with hemorrhagic stroke have approximately 7.46 times the odds of dying compared to those with ischemic stroke.ConclusionSignificant gaps exist in the epidemiology and quality indicators of pediatric stroke care compared to adult protocols. Implementing a “Pediatric code stroke” protocol and conducting prospective studies are crucial for improving pediatric stroke care and outcomes.
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spelling doaj-art-101fdf656f684c6098008dbb171cd8aa2025-08-20T02:31:08ZengFrontiers Media S.A.Frontiers in Neurology1664-22952024-12-011510.3389/fneur.2024.14561341456134Clinical characteristics and quality care indicators of pediatric stroke in a referral center of Colombia: eleven-year experience (pediastroke)Valeria Valencia-Cifuentes0Valeria Valencia-Cifuentes1Natalia Llanos-Leyton2Maria Camila Gómez-Ayala3Camila Ariza-Insignares4Camila Ariza-Insignares5Julian Alejandro Rivillas6Julian Alejandro Rivillas7Julian Alejandro Rivillas8Ana María Granados-Sánchez9Ana María Granados-Sánchez10Juan Camilo Márquez11Juan Camilo Márquez12Laura Galvis-Blanco13Laura Galvis-Blanco14Laura Galvis-Blanco15Santiago Cruz-Zamorano16Santiago Cruz-Zamorano17Santiago Cruz-Zamorano18Juan Fernando Gómez-Castro19Juan Fernando Gómez-Castro20Juan Fernando Gómez-Castro21Rubén Eduardo Lasso22Rubén Eduardo Lasso23Rubén Eduardo Lasso24Luis Miguel Rámirez-Muñoz25Juan Manuel Castro-Varela26Paula Andrea Benavides-Llano27Paula Andrea Benavides-Llano28Pablo Amaya29Pablo Amaya30Servicio de Neurología, Fundación Valle del Lili, Cali, ColombiaDepartamento de Ciencias Clínicas, Universidad Icesi, Cali, ColombiaCentro de Investigaciones Clínicas, Fundación Valle del Lili, Cali, ColombiaCentro de Investigaciones Clínicas, Fundación Valle del Lili, Cali, ColombiaDepartamento de Ciencias Clínicas, Universidad Icesi, Cali, ColombiaServicio de Medicina Materno-Infantil, Fundación Valle del Lili, Cali, ColombiaServicio de Neurología, Fundación Valle del Lili, Cali, ColombiaDepartamento de Ciencias Clínicas, Universidad Icesi, Cali, ColombiaDepartamento de Salud Pública y Medicina Comunitaria, Universidad Icesi, Cali, ColombiaDepartamento de Ciencias Clínicas, Universidad Icesi, Cali, ColombiaServicio de Radiología, Fundación Valle del Lili, Cali, ColombiaDepartamento de Ciencias Clínicas, Universidad Icesi, Cali, ColombiaServicio de Radiología, Fundación Valle del Lili, Cali, ColombiaDepartamento de Ciencias Clínicas, Universidad Icesi, Cali, ColombiaServicio de Medicina Materno-Infantil, Fundación Valle del Lili, Cali, ColombiaServicio de Emergencias Pediátricas, Fundación Valle del Lili, Cali, ColombiaDepartamento de Ciencias Clínicas, Universidad Icesi, Cali, ColombiaServicio de Medicina Materno-Infantil, Fundación Valle del Lili, Cali, ColombiaServicio de Neurología Pediátrica, Fundación Valle del Lili, Cali, ColombiaDepartamento de Ciencias Clínicas, Universidad Icesi, Cali, ColombiaServicio de Medicina Materno-Infantil, Fundación Valle del Lili, Cali, ColombiaServicio de Neurología Pediátrica, Fundación Valle del Lili, Cali, ColombiaDepartamento de Ciencias Clínicas, Universidad Icesi, Cali, ColombiaServicio de Medicina Materno-Infantil, Fundación Valle del Lili, Cali, ColombiaUnidad de Cuidados Intensivos Pediátricos, Fundación Valle del Lili, Cali, ColombiaDepartamento de Ciencias Clínicas, Universidad Icesi, Cali, ColombiaDepartamento de Ciencias Clínicas, Universidad Icesi, Cali, ColombiaDepartamento de Ciencias Clínicas, Universidad Icesi, Cali, ColombiaServicio de Medicina Materno-Infantil, Fundación Valle del Lili, Cali, ColombiaServicio de Neurología, Fundación Valle del Lili, Cali, ColombiaDepartamento de Ciencias Clínicas, Universidad Icesi, Cali, ColombiaObjectiveThis study aims to describe clinical variables and quality care indicators in pediatric stroke management at a high-complexity pediatric care center in Latin America.MethodsRetrospective study of patients with stroke, aged 2–18 years from 2011 to 2021. The principal outcomes were the mRs and mortality. Differences between groups were assessed using Fisher’s exact test and the Mann–Whitney U test. We used logistic regression to explore the association between characteristics reported as relevant in literature and mortality.ResultsOne hundred thirty six patients included, with a median age of 11 years, 54% were male. 47% were hemorrhagic strokes, followed by ischemic strokes at 39%. One-third of the cases presented in hospital. 51% of the patients had no prior medical history. The most common symptoms were altered consciousness, headache, and hemiparesis. The median door-to-image time was 123 min. The most frequent etiologies in ischemic stroke were arteriopathies and cardiac pathology, while vascular malformation and coagulopathies were predominant in hemorrhagic stroke. No patient received reperfusion therapy. At discharge, 48% of patients had a favorable mRs. The mortality rate was 21%. Patients with in-hospital stroke have approximately 7.37 times the odds of dying compared to those with out-of-hospital stroke. Patients with hemorrhagic stroke have approximately 7.46 times the odds of dying compared to those with ischemic stroke.ConclusionSignificant gaps exist in the epidemiology and quality indicators of pediatric stroke care compared to adult protocols. Implementing a “Pediatric code stroke” protocol and conducting prospective studies are crucial for improving pediatric stroke care and outcomes.https://www.frontiersin.org/articles/10.3389/fneur.2024.1456134/fullstrokepediatricscerebral ischemiacerebral hemorrhagemortalityquality indicators
spellingShingle Valeria Valencia-Cifuentes
Valeria Valencia-Cifuentes
Natalia Llanos-Leyton
Maria Camila Gómez-Ayala
Camila Ariza-Insignares
Camila Ariza-Insignares
Julian Alejandro Rivillas
Julian Alejandro Rivillas
Julian Alejandro Rivillas
Ana María Granados-Sánchez
Ana María Granados-Sánchez
Juan Camilo Márquez
Juan Camilo Márquez
Laura Galvis-Blanco
Laura Galvis-Blanco
Laura Galvis-Blanco
Santiago Cruz-Zamorano
Santiago Cruz-Zamorano
Santiago Cruz-Zamorano
Juan Fernando Gómez-Castro
Juan Fernando Gómez-Castro
Juan Fernando Gómez-Castro
Rubén Eduardo Lasso
Rubén Eduardo Lasso
Rubén Eduardo Lasso
Luis Miguel Rámirez-Muñoz
Juan Manuel Castro-Varela
Paula Andrea Benavides-Llano
Paula Andrea Benavides-Llano
Pablo Amaya
Pablo Amaya
Clinical characteristics and quality care indicators of pediatric stroke in a referral center of Colombia: eleven-year experience (pediastroke)
Frontiers in Neurology
stroke
pediatrics
cerebral ischemia
cerebral hemorrhage
mortality
quality indicators
title Clinical characteristics and quality care indicators of pediatric stroke in a referral center of Colombia: eleven-year experience (pediastroke)
title_full Clinical characteristics and quality care indicators of pediatric stroke in a referral center of Colombia: eleven-year experience (pediastroke)
title_fullStr Clinical characteristics and quality care indicators of pediatric stroke in a referral center of Colombia: eleven-year experience (pediastroke)
title_full_unstemmed Clinical characteristics and quality care indicators of pediatric stroke in a referral center of Colombia: eleven-year experience (pediastroke)
title_short Clinical characteristics and quality care indicators of pediatric stroke in a referral center of Colombia: eleven-year experience (pediastroke)
title_sort clinical characteristics and quality care indicators of pediatric stroke in a referral center of colombia eleven year experience pediastroke
topic stroke
pediatrics
cerebral ischemia
cerebral hemorrhage
mortality
quality indicators
url https://www.frontiersin.org/articles/10.3389/fneur.2024.1456134/full
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