Abstract T P328: Hypertension is Associated With Increased Mortality in Children Admitted With Ischemic Stroke
Objective: To assess the association between hypertension (HTN) and outcome after ischemic stroke in children from a large national sample.
Methods: Using the Healthcare Cost and Utilization Project Kids’ Inpatient Database, children (1-18 years) with a primary diagnosis of ischemic stroke (ICD-9 codes 433-437.1) that also had a diagnosis of elevated BP (ICD-9 code 796.2) or HTN (ICD-9 codes 401 and 405) from 2003, 2006, and 2009 were identified. Clinical characteristics, discharge outcomes, and hospital costs were assessed. Multivariate logistic regression was used to assess the relationship between hypertension and in-hospital mortality or discharge outcomes; after adjusting for age, gender, and renal failure.
Results: Of 2,590 children admitted with ischemic stroke, 156 (6%) also had a diagnosis of HTN (although HTN is likely underdiagnosed as age and sex adjusted BP values ≥95th percentile are required). HTN was associated with renal failure in 10% of the children. Concurrent HTN was associated with increased mortality among patients with ischemic stroke compared to those without HTN (7.4% vs. 2.8%; p=0.01), increased length of stay (mean 11±17 days vs. 7±12 days; p<.0001) and higher hospital costs (mean $85,569±137,854 vs. $50,992±96,349; p<.0001). After adjusting for age, gender and renal failure, children with HTN had three folds higher odds of in-hospital death [odds ratio (OR) 3.3, 95% confidence interval (CI) (1.4-8.0, p=0.005)] and lower odds of none to minimal disability at discharge (Table).
Conclusion: HTN was associated with a 3 times greater odds of death in the hospital for children presenting with ischemic stroke and may represent a potentially modifiable risk factor for poor outcome.
Author Disclosures: M.M. Adil: None. A. Caceres: None. A.I. Qureshi: None. L.C. Jordan: None.
- © 2014 by American Heart Association, Inc.