Dataset Information

Transient ischemic attack requiring hospitalization of children in the United States: kids' inpatient database 2003 to 2009.

ABSTRACT: Transient ischemic attacks (TIA) are not well described in children. We assessed the prevalence of risk factors for TIA requiring hospitalization in children in a large national database.Using the Healthcare Cost and Utilization Project Kids' Inpatient Database, children aged 1 to 18 years admitted for TIA in 2003, 2006, and 2009 were identified by International Classification of Diseases, Ninth Revision, Clinical Modification code 435. Descriptive analyses identified patient characteristics. Trend analysis determined the change in annual average hospitalization days from 2003 to 2009.TIA was the primary diagnosis for 531 children. Important secondary diagnoses included sickle cell disease (20%), congenital heart disease (11%), migraine (12%), moyamoya disease (10%), and stroke (4%). Mean length of stay decreased from 3.0 days (95% confidence interval, 2.4-3.6) in 2003 to 2.3 days (95% confidence interval, 2.0-2.7) in 2009 (P=0.04). During the same period, 2590 children were admitted with ischemic stroke; 4.8 children with stroke were admitted for every child with TIA.Recognized risk factors for TIA, including sickle cell disease, congenital heart disease, moyamoya, recent stroke, and migraine, were present in <60% of children. Pediatric admissions for ischemic stroke were ?5-fold more common than for TIA. Further study is required to understand the risk of stroke after TIA in children to guide appropriate evaluation and treatment.

SUBMITTER: Adil MM

PROVIDER: S-EPMC3954473 | biostudies-literature | 2014 Mar

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Transient ischemic attack requiring hospitalization of children in the United States: kids' inpatient database 2003 to 2009.

Adil Malik M MM Qureshi Adnan I AI Beslow Lauren A LA Jordan Lori C LC

Stroke 20140212 3

<h4>Background and purpose</h4>Transient ischemic attacks (TIA) are not well described in children. We assessed the prevalence of risk factors for TIA requiring hospitalization in children in a large national database.<h4>Methods</h4>Using the Healthcare Cost and Utilization Project Kids' Inpatient Database, children aged 1 to 18 years admitted for TIA in 2003, 2006, and 2009 were identified by International Classification of Diseases, Ninth Revision, Clinical Modification code 435. Descriptive ...[more]

PMID: 24523040

Similar Datasets

Project description:BackgroundPatients with ischemic stroke or transient ischemic attack (TIA) are at increased risk for future cardiovascular events despite current preventive therapies. The identification of insulin resistance as a risk factor for stroke and myocardial infarction raised the possibility that pioglitazone, which improves insulin sensitivity, might benefit patients with cerebrovascular disease.MethodsIn this multicenter, double-blind trial, we randomly assigned 3876 patients who had had a recent ischemic stroke or TIA to receive either pioglitazone (target dose, 45 mg daily) or placebo. Eligible patients did not have diabetes but were found to have insulin resistance on the basis of a score of more than 3.0 on the homeostasis model assessment of insulin resistance (HOMA-IR) index. The primary outcome was fatal or nonfatal stroke or myocardial infarction.ResultsBy 4.8 years, a primary outcome had occurred in 175 of 1939 patients (9.0%) in the pioglitazone group and in 228 of 1937 (11.8%) in the placebo group (hazard ratio in the pioglitazone group, 0.76; 95% confidence interval [CI], 0.62 to 0.93; P=0.007). Diabetes developed in 73 patients (3.8%) and 149 patients (7.7%), respectively (hazard ratio, 0.48; 95% CI, 0.33 to 0.69; P<0.001). There was no significant between-group difference in all-cause mortality (hazard ratio, 0.93; 95% CI, 0.73 to 1.17; P=0.52). Pioglitazone was associated with a greater frequency of weight gain exceeding 4.5 kg than was placebo (52.2% vs. 33.7%, P<0.001), edema (35.6% vs. 24.9%, P<0.001), and bone fracture requiring surgery or hospitalization (5.1% vs. 3.2%, P=0.003).ConclusionsIn this trial involving patients without diabetes who had insulin resistance along with a recent history of ischemic stroke or TIA, the risk of stroke or myocardial infarction was lower among patients who received pioglitazone than among those who received placebo. Pioglitazone was also associated with a lower risk of diabetes but with higher risks of weight gain, edema, and fracture. (Funded by the National Institute of Neurological Disorders and Stroke; ClinicalTrials.gov number, NCT00091949.).

Dataset Information

Transient ischemic attack requiring hospitalization of children in the United States: kids' inpatient database 2003 to 2009.

Publications

Transient ischemic attack requiring hospitalization of children in the United States: kids' inpatient database 2003 to 2009.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets