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Incidence, Characteristics, and Outcomes of Stroke in Pediatric Patients with Celiac Disease

(1) Background: Celiac disease (CD) can cause long-term inflammation and endothelial dysfunction and has been cited as a risk factor for acute ischemic stroke (AIS) in pediatric patients. However, the rate and outcomes of AIS in pediatric patients with CD has not been explored in a large population....

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Autores principales: Vazquez, Sima, Thaker, Akash, Nolan, Bridget, Spirollari, Eris, Clare, Kevin, Wolf, Steven, McGoldrick, Patricia, Nuoman, Rolla, Overby, Philip, Al-Mufti, Fawaz
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10381719/
https://www.ncbi.nlm.nih.gov/pubmed/37511820
http://dx.doi.org/10.3390/life13071445
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author Vazquez, Sima
Thaker, Akash
Nolan, Bridget
Spirollari, Eris
Clare, Kevin
Wolf, Steven
McGoldrick, Patricia
Nuoman, Rolla
Overby, Philip
Al-Mufti, Fawaz
author_facet Vazquez, Sima
Thaker, Akash
Nolan, Bridget
Spirollari, Eris
Clare, Kevin
Wolf, Steven
McGoldrick, Patricia
Nuoman, Rolla
Overby, Philip
Al-Mufti, Fawaz
author_sort Vazquez, Sima
collection PubMed
description (1) Background: Celiac disease (CD) can cause long-term inflammation and endothelial dysfunction and has been cited as a risk factor for acute ischemic stroke (AIS) in pediatric patients. However, the rate and outcomes of AIS in pediatric patients with CD has not been explored in a large population. Our objective is to explore the rate, severity, and outcomes of CD amongst pediatric AIS patients on a nationwide level. (2) Methods: The National Inpatient Sample (NIS) database was queried from 2016 to 2020 for pediatric patients with a principal diagnosis of AIS. Patients with a concurrent diagnosis of CD (AIS-CD) were compared to those without (AIS). Baseline demographics and comorbidities, clinical variables of severity, hospital complications, and the rates of tissue plasminogen activator (tPA) and mechanical thrombectomy were compared between the two groups. The main outcomes studied were mortality, discharge disposition, length of stay (LOS), and total hospital charges. (3) Results: Of 12,755 pediatric patients with a principal diagnosis of AIS, 75 (0.6%) had concurrent CD. There were no differences in the severity, discharge disposition, or mortality between the AIS-CD and AIS patients. Patients with AIS-CD were more likely to receive tPA at an outside hospital within 24 h of admission (p < 0.01) and more likely to undergo mechanical thrombectomy (p < 0.01) compared to the AIS patients. (4) Conclusions: CD patients made up only 0.6% of all pediatric AIS patients. No differences in the severity, mortality, or discharge disposition suggests a minimal to absent role of CD in the etiology of stroke. The CD-AIS patients were more likely to receive a tPA or undergo a mechanical thrombectomy; studies are needed to confirm the safety and efficacy of these interventions in pediatric patients.
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spelling pubmed-103817192023-07-29 Incidence, Characteristics, and Outcomes of Stroke in Pediatric Patients with Celiac Disease Vazquez, Sima Thaker, Akash Nolan, Bridget Spirollari, Eris Clare, Kevin Wolf, Steven McGoldrick, Patricia Nuoman, Rolla Overby, Philip Al-Mufti, Fawaz Life (Basel) Article (1) Background: Celiac disease (CD) can cause long-term inflammation and endothelial dysfunction and has been cited as a risk factor for acute ischemic stroke (AIS) in pediatric patients. However, the rate and outcomes of AIS in pediatric patients with CD has not been explored in a large population. Our objective is to explore the rate, severity, and outcomes of CD amongst pediatric AIS patients on a nationwide level. (2) Methods: The National Inpatient Sample (NIS) database was queried from 2016 to 2020 for pediatric patients with a principal diagnosis of AIS. Patients with a concurrent diagnosis of CD (AIS-CD) were compared to those without (AIS). Baseline demographics and comorbidities, clinical variables of severity, hospital complications, and the rates of tissue plasminogen activator (tPA) and mechanical thrombectomy were compared between the two groups. The main outcomes studied were mortality, discharge disposition, length of stay (LOS), and total hospital charges. (3) Results: Of 12,755 pediatric patients with a principal diagnosis of AIS, 75 (0.6%) had concurrent CD. There were no differences in the severity, discharge disposition, or mortality between the AIS-CD and AIS patients. Patients with AIS-CD were more likely to receive tPA at an outside hospital within 24 h of admission (p < 0.01) and more likely to undergo mechanical thrombectomy (p < 0.01) compared to the AIS patients. (4) Conclusions: CD patients made up only 0.6% of all pediatric AIS patients. No differences in the severity, mortality, or discharge disposition suggests a minimal to absent role of CD in the etiology of stroke. The CD-AIS patients were more likely to receive a tPA or undergo a mechanical thrombectomy; studies are needed to confirm the safety and efficacy of these interventions in pediatric patients. MDPI 2023-06-26 /pmc/articles/PMC10381719/ /pubmed/37511820 http://dx.doi.org/10.3390/life13071445 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Vazquez, Sima
Thaker, Akash
Nolan, Bridget
Spirollari, Eris
Clare, Kevin
Wolf, Steven
McGoldrick, Patricia
Nuoman, Rolla
Overby, Philip
Al-Mufti, Fawaz
Incidence, Characteristics, and Outcomes of Stroke in Pediatric Patients with Celiac Disease
title Incidence, Characteristics, and Outcomes of Stroke in Pediatric Patients with Celiac Disease
title_full Incidence, Characteristics, and Outcomes of Stroke in Pediatric Patients with Celiac Disease
title_fullStr Incidence, Characteristics, and Outcomes of Stroke in Pediatric Patients with Celiac Disease
title_full_unstemmed Incidence, Characteristics, and Outcomes of Stroke in Pediatric Patients with Celiac Disease
title_short Incidence, Characteristics, and Outcomes of Stroke in Pediatric Patients with Celiac Disease
title_sort incidence, characteristics, and outcomes of stroke in pediatric patients with celiac disease
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10381719/
https://www.ncbi.nlm.nih.gov/pubmed/37511820
http://dx.doi.org/10.3390/life13071445
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