Stephanie N Chen, Jessica B Holstine, Julie Balch Samora
Reducing Rigid Immobilization for Toddler's Fractures: A Quality Improvement Initiative
Pediatric quality & safety
despite strong evidence endovascular therapy adults acute arterial ischemic stroke limited data exist children aimed describe endovascular therapy utilization explore outcomes national sample pediatric arterial ischemic stroke queried 2012 kids inpatient database children aged greater 28 days 20 years international classification diseases ninth revision clinical modification icd9cm codes arterial ischemic stroke evaluated groups based procedure code endovascular therapy poor outcome defined need tracheostomy gastrostomy discharge rehabilitation facility death logistic regression evaluated association endovascular therapy poor outcome adjusted age disease severity hemiplegia critical care interventions neurosurgical interventions comorbidities identified 3184 pediatric discharges diagnosis code arterial ischemic stroke thirtyeight 1 endovascular therapy procedure code endovascular therapy patients older 102 versus 45 years p 0001 likely hemiplegiaparesis relative risk rr 38 95 confidence interval ci 2074 aphasia rr 53 95 ci 28101 facial droop rr 40 95 ci 1987 endovascular therapy associated critical care neurosurgical interventions intracranial hemorrhage length hospitalization mortality discharge disposition similar groups multivariable model endovascular therapy associated poor outcome adjusted odds ratio 17 95 ci 0741 national sample children diagnosis arterial ischemic stroke endovascular therapy infrequently utilized patients procedure code endovascular therapy significant strokerelated deficits outcomes similar children receive endovascular therapy data conjunction evidence benefit adults support consideration endovascular therapy select children acute stroke