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Published Online
on November 21, 2007

Stroke. 2007
Published online before print November 21, 2007, doi: 10.1161/STROKEAHA.107.497420
A more recent version of this article appeared on January 1, 2008
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Right arrow Stroke in Children and the Young

Submitted on June 22, 2007
Accepted on June 26, 2007

The Cost of Pediatric Stroke Care and Rehabilitation

Warren Lo MD*; Khaled Zamel MD; Kavita Ponnappa BS; Antoni Allen BS; Deena Chisolm PhD; Monica Tang; Bryce Kerlin MD; and Keith O. Yeates PhD

From the Departments of Pediatrics and Psychology, The Ohio State University and Children’s Hospital, Columbus, Ohio.

* To whom correspondence should be addressed. E-mail: wlo{at}chi.osu.edu.

Background and Purpose—There is little data regarding the cost of pediatric stroke care or the elements that contribute to these costs. We examined costs for poststroke care during the first year after diagnosis and compared these costs with the volume of the cerebral infarct and the level of neurological and functional outcome.

Methods—We identified 39 children who sustained nontraumatic ischemic or hemorrhagic strokes and confirmed the diagnoses by review of medical and radiology records. Medical costs were tabulated for the year after the diagnosis of stroke. Cerebral infarct volumes were measured from MRI or CT scans. Neurological outcome was assessed by telephone with a modification of the Pediatric Stroke Outcome Measure (PSOM), and functional outcomes were assessed with a standardized quality-of-life measure.

Results—The median cost for poststroke care during the year after diagnosis was $42 338 for the entire group. The cost for stroke care was higher for hemorrhagic stroke than for ischemic stroke. Cost had a significant positive correlation with neurological impairment. The modified PSOM score positively correlated with impairments of physical, emotional, social, and school function.

Conclusions—The cost of stroke care may be one measure of stroke severity, with more extensive strokes resulting in greater medical costs. In addition, stroke appears to impair children’s social ability along with their neurological function.


Key words: cost • infarct volume • outcome • pediatric • quality of life • stroke