Acute triage of childhood stroke in Denmark
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Acute triage of childhood stroke in Denmark. / Bindslev, Julie Brix; Hansen, Klaus; Laugesen, Nicolaj Groenbaek; Benndorf, Goetz; Hoei-Hansen, Christina Engel; Truelsen, Thomas.
I: European Stroke Journal, Bind 8, Nr. 2, 2023, s. 483–491.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Acute triage of childhood stroke in Denmark
AU - Bindslev, Julie Brix
AU - Hansen, Klaus
AU - Laugesen, Nicolaj Groenbaek
AU - Benndorf, Goetz
AU - Hoei-Hansen, Christina Engel
AU - Truelsen, Thomas
PY - 2023
Y1 - 2023
N2 - Objective: This 2-year observational study aimed to test the feasibility of implementing a pediatric stroke triage-setup that connected frontline providers with vascular neurologists and to examine final diagnoses in children triaged for suspected stroke. Methods: Prospective, consecutive registration of children with suspected stroke triaged by a team of vascular neurologists from Jan 1st, 2020 and through Dec 2021, Eastern Denmark (census 530,000 children). Based on the provided clinical information, the children were triaged to either assessment at the Comprehensive Stroke Center (CSC) in Copenhagen or to a pediatric department. All included children were retrospectively followed-up for clinical presentations and final diagnosis. Results: A total of 163 children with 166 suspected stroke events were triaged by the vascular neurologists. Cerebrovascular disease was present in 15 (9.0%) suspected stroke events; one child had intracerebral hemorrhage, one had subarachnoid hemorrhage, two children presented with three TIA events and nine children presented with 10 ischemic stroke events. Two children with ischemic stroke were eligible for acute revascularization treatment of which both were triaged to the CSC. The sensitivity of the triage by acute revascularization indication was 1.00 (95% confidence interval (95% CI): 0.15-1.00) and specificity 0.65 (95% CI: 0.57-0.73). Non-stroke neurological emergencies were present in 34 (20.5%) children, including seizures in 18 (10.8%) and acute demyelinating disorders in 7 (4.2%). Conclusion: Implementing regional triage-setup that connected frontline providers to vascular neurologists was feasible; this system was activated for the majority of children with ischemic stroke according to an expected incidence and led to identification of children eligible for revascularization treatments.
AB - Objective: This 2-year observational study aimed to test the feasibility of implementing a pediatric stroke triage-setup that connected frontline providers with vascular neurologists and to examine final diagnoses in children triaged for suspected stroke. Methods: Prospective, consecutive registration of children with suspected stroke triaged by a team of vascular neurologists from Jan 1st, 2020 and through Dec 2021, Eastern Denmark (census 530,000 children). Based on the provided clinical information, the children were triaged to either assessment at the Comprehensive Stroke Center (CSC) in Copenhagen or to a pediatric department. All included children were retrospectively followed-up for clinical presentations and final diagnosis. Results: A total of 163 children with 166 suspected stroke events were triaged by the vascular neurologists. Cerebrovascular disease was present in 15 (9.0%) suspected stroke events; one child had intracerebral hemorrhage, one had subarachnoid hemorrhage, two children presented with three TIA events and nine children presented with 10 ischemic stroke events. Two children with ischemic stroke were eligible for acute revascularization treatment of which both were triaged to the CSC. The sensitivity of the triage by acute revascularization indication was 1.00 (95% confidence interval (95% CI): 0.15-1.00) and specificity 0.65 (95% CI: 0.57-0.73). Non-stroke neurological emergencies were present in 34 (20.5%) children, including seizures in 18 (10.8%) and acute demyelinating disorders in 7 (4.2%). Conclusion: Implementing regional triage-setup that connected frontline providers to vascular neurologists was feasible; this system was activated for the majority of children with ischemic stroke according to an expected incidence and led to identification of children eligible for revascularization treatments.
KW - Pediatric stroke
KW - pathway
KW - protocol
KW - triage
KW - revascularization
KW - feasibility studies
KW - ARTERIAL ISCHEMIC-STROKE
KW - HEALTH-CARE PROFESSIONALS
KW - PEDIATRIC STROKE
KW - DIAGNOSIS
KW - DEFINITION
KW - STATEMENT
KW - IMPROVES
KW - CHILDREN
KW - TIME
KW - RISK
U2 - 10.1177/23969873231161381
DO - 10.1177/23969873231161381
M3 - Journal article
C2 - 37231690
VL - 8
SP - 483
EP - 491
JO - European Stroke Journal
JF - European Stroke Journal
SN - 2396-9873
IS - 2
ER -
ID: 341280606