Recent trauma and acute infection as risk factors for childhood arterial ischemic stroke.
Recent trauma and acute infection as risk factors for childhood arterial ischemic stroke.
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DOI：
10.1002/ana.23688
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发表时间：
2012-12
影响因子：
11.2
通讯作者：
Fullerton, Heather J.
中科院分区：
文献类型：
--
作者：
Hills, Nancy K.;Johnston, S. Claiborne;Sidney, Stephen;Zielinski, Brandon A.;Fullerton, Heather J.
创伤和急性感染一直与成人中风有关，在儿童中也是普遍的暴露。我们假设这些环境因素与儿童动脉缺血性中风(AIS)独立相关。在一项病例对照研究中，250万名儿童(≤，19岁)参加了综合保健计划(1993年至2007年)，从电子记录中确定了儿童急性呼吸综合征病例(n=126)，并通过查阅图表进行了确认。年龄和设施匹配的对照组(n=378)是从队列中随机选择的。暴露于中风诊断之前的医疗记录，或配对对照的相同日期确定；时间窗口是先验定义的。在过去12周内因头部或颈部创伤就诊是儿童AIS的独立危险因素(优势比[OR]7.5，95%可信区间[CI]2.9，19.3)，出现在12%的病例中(对照组的1.6%)。从创伤到中风的中位时间为0.5天(四分位数范围为0，2天)；特别后对创伤暴露的重新定义(前1周)与AIS：OR 39(95%CI 5.1,298)有更强的相关性。轻微急性感染的就医经历(前4周)也是一个独立的危险因素(OR 4.6，95%CI 2.6，8.2)，出现在33%的病例(13%的对照)中。未发现单一感染类型。只有两例接触过创伤和感染。创伤和急性感染是儿童AIS常见的独立危险因素，可能是卒中预防策略的目标。
Trauma and acute infection have been associated with stroke in adults, and are prevalent exposures in children. We hypothesized that these environmental factors are independently associated with childhood arterial ischemic stroke (AIS). In a case-control study nested within a cohort of 2.5 million children (≤ 19 years old) enrolled in an integrated health care plan (1993–2007), childhood AIS cases (n=126) were identified from electronic records and confirmed through chart review. Age- and facility-matched controls (n=378) were randomly selected from the cohort. Exposures were determined from review of medical records prior to the stroke diagnosis, or the same date for the paired controls; time windows were defined a priori. A medical encounter for head or neck trauma within the prior 12 weeks was an independent risk factor for childhood AIS (odds ratio [OR] 7.5, 95% confidence interval [CI] 2.9, 19.3), present in 12% of cases (1.6% of controls). Median time from trauma to stroke was 0.5 days (interquartile range 0, 2 days); post-hoc redefinition of trauma exposure (prior 1 week) was more strongly associated with AIS: OR 39 (95% CI 5.1, 298). A medical encounter for a minor acute infection (prior 4 weeks) was also an independent risk factor (OR 4.6, 95% CI 2.6, 8.2), present in 33% of cases (13% of controls). No single infection type predominated. Only two cases had exposure to trauma and infection. Trauma and acute infection are common independent risk factors for childhood AIS, and may be targets for stroke prevention strategies.
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影响因子：
9.9
作者：
Gardner, M. A.;Hills, N. K.;Fullerton, H. J.
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通讯作者：
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