Abstract Number: PB0107
Meeting: ISTH 2020 Congress
Background: Acute ischemic stroke (AIS) in children has not been well studied. Its management and clinical characteristics remain incompletely understood.
Aims: This study examines characteristics, antithrombotic treatment, and recurrence among pediatric subjects with AIS using healthcare claims databases.
Methods: Using three US healthcare claims databases (IBM MarketScan® Commercial (CCAE), Multi‐state Medicaid (MDCD), and Optum® De-Identified Clinformatics® Data Mart Database – Socio-Economic Status (SES)) pediatric (< 18 years) subjects with hospitalized AIS were identified between 2008-01-01 and 2018-12-31. Demographics, comorbidities, and prescription drug exposures six months prior to hospitalization and treatment with anticoagulants (warfarin and direct anticoagulants (DOACs)) and antiplatelets (P2Y12 inhibitors (P2Y12i)) 30 days after hospitalization were examined. Crude incidence rates (IR, /1000 person-years) in 1 year after first AIS were examined and stratified by gender and age group (0-1; 2-5; 6-11; and 12-17 years).
Results: Among the pediatric AIS subjects identified from 3 databases (N=1240 (CCAE); N=1120 (MDCD); N=423 (SES)) the mean age was 10.5, 9.2, and 9.9 years respectively. The majority of pediatric AIS subjects were not treated with DOACs, warfarin, or P2Y12i medications in 30 days after AIS (range 96-98%). The rates of recurrent AIS (IR) in 1 year after first AIS were (148.0, 140.7, 76.6/1000 person-years). AIS recurrence (IR) were higher among females compared to males in CCAE (189.4 vs. 114.9/1000 person-years) and SES (86.6 vs. 68.7/1000 subject-years) but not in MDCD (139.8 vs. 141.6/1000 person-years). AIS recurrence (IR) in 1 year were higher among the 2-5 years age group (range 112.6-207.6/1000 person-years) compared to all other age groups.
Conclusions: Our study shows prescription antithrombotic therapies are rarely used in spite of relatively high AIS recurrence rates in pediatric AIS subjects. Future studies may assess whether recurrence rates differ by known risk factors.
To cite this abstract in AMA style:Hardin J, Wang L, Yuan Z, Patino H, Weaver J. Characteristics and Recurrence of Acute Ischemic Stroke in Children: An Examination Using Real World Data [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/characteristics-and-recurrence-of-acute-ischemic-stroke-in-children-an-examination-using-real-world-data/. Accessed January 27, 2022.
« Back to ISTH 2020 Congress
ISTH Congress Abstracts - https://abstracts.isth.org/abstract/characteristics-and-recurrence-of-acute-ischemic-stroke-in-children-an-examination-using-real-world-data/