Risk of recurrent stroke in children with sickle cell disease receiving blood transfusion therapy for at least five years after initial stroke

Douglas J. Scothorn, Cynthia Price, Daniel Schwartz, Cindy Terrill, George R. Buchanan, Wanda Shurney, Ingrid Sarniak, Robert Fallon, Jen Yih Chu, Charles H. Pegelow, Winfred Wang, James F. Casella, Linda S. Resar, Brian Berman, Thomas Adamkiewicz, Lewis L. Hsu, Kwaku Ohene-Frempong, Kim Smith-Whitley, Donald Mahoney, J. Paul ScottGerald M. Woods, Masayo Watanabe, Michael R. DeBaun

Research output: Contribution to journalArticle

172 Citations (Scopus)

Abstract

Objective: To test the hypothesis that children with sickle cell disease (SCD) who have an initial stroke temporally unrelated to another medical event are at higher risk for recurrent stroke than are children who had strokes temporally related to medical events. Methods: A retrospective cohort study of children with SCD and stroke who received regularly scheduled blood transfusions for a minimum of 5 years was conducted. Medical records were examined for the documentation of antecedent or concurrent medical events (hypertension, acute chest syndrome, aplastic crisis, fever associated with infection, exchange transfusion) associated with physician contact within 14 days before the initial stroke. Results: A total of 137 pediatric patients from 14 centers were studied. Mean age at first stroke was 6.3 years (1.4 to 14.0 years) with mean follow-up of 10.1 years (5 to 24 years). Thirty-one (22%) patients had a second stroke (2.2 per 100 patient years); 26 patients had an identified medical or concurrent event associated with their initial stroke. None of these patients had recurrent stroke 2 or more years after the initial event. The remaining 111 patients had an ongoing risk of recurrent stroke (1.9 per 100 patient-years) despite long-term transfusions (P = .038). Conclusions: The absence of an antecedent or concurrent medical event associated with an initial stroke is a major risk factor for subsequent stroke while receiving regular transfusions.

Original languageEnglish (US)
Pages (from-to)348-354
Number of pages7
JournalJournal of Pediatrics
Volume140
Issue number3
DOIs
StatePublished - 2002
Externally publishedYes

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Sickle Cell Anemia
Blood Transfusion
Stroke
Therapeutics
Acute Chest Syndrome
Documentation
Medical Records
Cohort Studies
Fever
Retrospective Studies
Pediatrics
Hypertension
Physicians

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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Risk of recurrent stroke in children with sickle cell disease receiving blood transfusion therapy for at least five years after initial stroke. / Scothorn, Douglas J.; Price, Cynthia; Schwartz, Daniel; Terrill, Cindy; Buchanan, George R.; Shurney, Wanda; Sarniak, Ingrid; Fallon, Robert; Chu, Jen Yih; Pegelow, Charles H.; Wang, Winfred; Casella, James F.; Resar, Linda S.; Berman, Brian; Adamkiewicz, Thomas; Hsu, Lewis L.; Ohene-Frempong, Kwaku; Smith-Whitley, Kim; Mahoney, Donald; Scott, J. Paul; Woods, Gerald M.; Watanabe, Masayo; DeBaun, Michael R.

In: Journal of Pediatrics, Vol. 140, No. 3, 2002, p. 348-354.

Research output: Contribution to journalArticle

Scothorn, DJ, Price, C, Schwartz, D, Terrill, C, Buchanan, GR, Shurney, W, Sarniak, I, Fallon, R, Chu, JY, Pegelow, CH, Wang, W, Casella, JF, Resar, LS, Berman, B, Adamkiewicz, T, Hsu, LL, Ohene-Frempong, K, Smith-Whitley, K, Mahoney, D, Scott, JP, Woods, GM, Watanabe, M & DeBaun, MR 2002, 'Risk of recurrent stroke in children with sickle cell disease receiving blood transfusion therapy for at least five years after initial stroke', Journal of Pediatrics, vol. 140, no. 3, pp. 348-354. https://doi.org/10.1067/mpd.2002.122498
Scothorn, Douglas J. ; Price, Cynthia ; Schwartz, Daniel ; Terrill, Cindy ; Buchanan, George R. ; Shurney, Wanda ; Sarniak, Ingrid ; Fallon, Robert ; Chu, Jen Yih ; Pegelow, Charles H. ; Wang, Winfred ; Casella, James F. ; Resar, Linda S. ; Berman, Brian ; Adamkiewicz, Thomas ; Hsu, Lewis L. ; Ohene-Frempong, Kwaku ; Smith-Whitley, Kim ; Mahoney, Donald ; Scott, J. Paul ; Woods, Gerald M. ; Watanabe, Masayo ; DeBaun, Michael R. / Risk of recurrent stroke in children with sickle cell disease receiving blood transfusion therapy for at least five years after initial stroke. In: Journal of Pediatrics. 2002 ; Vol. 140, No. 3. pp. 348-354.
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abstract = "Objective: To test the hypothesis that children with sickle cell disease (SCD) who have an initial stroke temporally unrelated to another medical event are at higher risk for recurrent stroke than are children who had strokes temporally related to medical events. Methods: A retrospective cohort study of children with SCD and stroke who received regularly scheduled blood transfusions for a minimum of 5 years was conducted. Medical records were examined for the documentation of antecedent or concurrent medical events (hypertension, acute chest syndrome, aplastic crisis, fever associated with infection, exchange transfusion) associated with physician contact within 14 days before the initial stroke. Results: A total of 137 pediatric patients from 14 centers were studied. Mean age at first stroke was 6.3 years (1.4 to 14.0 years) with mean follow-up of 10.1 years (5 to 24 years). Thirty-one (22{\%}) patients had a second stroke (2.2 per 100 patient years); 26 patients had an identified medical or concurrent event associated with their initial stroke. None of these patients had recurrent stroke 2 or more years after the initial event. The remaining 111 patients had an ongoing risk of recurrent stroke (1.9 per 100 patient-years) despite long-term transfusions (P = .038). Conclusions: The absence of an antecedent or concurrent medical event associated with an initial stroke is a major risk factor for subsequent stroke while receiving regular transfusions.",
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T1 - Risk of recurrent stroke in children with sickle cell disease receiving blood transfusion therapy for at least five years after initial stroke

AU - Scothorn, Douglas J.

AU - Price, Cynthia

AU - Schwartz, Daniel

AU - Terrill, Cindy

AU - Buchanan, George R.

AU - Shurney, Wanda

AU - Sarniak, Ingrid

AU - Fallon, Robert

AU - Chu, Jen Yih

AU - Pegelow, Charles H.

AU - Wang, Winfred

AU - Casella, James F.

AU - Resar, Linda S.

AU - Berman, Brian

AU - Adamkiewicz, Thomas

AU - Hsu, Lewis L.

AU - Ohene-Frempong, Kwaku

AU - Smith-Whitley, Kim

AU - Mahoney, Donald

AU - Scott, J. Paul

AU - Woods, Gerald M.

AU - Watanabe, Masayo

AU - DeBaun, Michael R.

PY - 2002

Y1 - 2002

N2 - Objective: To test the hypothesis that children with sickle cell disease (SCD) who have an initial stroke temporally unrelated to another medical event are at higher risk for recurrent stroke than are children who had strokes temporally related to medical events. Methods: A retrospective cohort study of children with SCD and stroke who received regularly scheduled blood transfusions for a minimum of 5 years was conducted. Medical records were examined for the documentation of antecedent or concurrent medical events (hypertension, acute chest syndrome, aplastic crisis, fever associated with infection, exchange transfusion) associated with physician contact within 14 days before the initial stroke. Results: A total of 137 pediatric patients from 14 centers were studied. Mean age at first stroke was 6.3 years (1.4 to 14.0 years) with mean follow-up of 10.1 years (5 to 24 years). Thirty-one (22%) patients had a second stroke (2.2 per 100 patient years); 26 patients had an identified medical or concurrent event associated with their initial stroke. None of these patients had recurrent stroke 2 or more years after the initial event. The remaining 111 patients had an ongoing risk of recurrent stroke (1.9 per 100 patient-years) despite long-term transfusions (P = .038). Conclusions: The absence of an antecedent or concurrent medical event associated with an initial stroke is a major risk factor for subsequent stroke while receiving regular transfusions.

AB - Objective: To test the hypothesis that children with sickle cell disease (SCD) who have an initial stroke temporally unrelated to another medical event are at higher risk for recurrent stroke than are children who had strokes temporally related to medical events. Methods: A retrospective cohort study of children with SCD and stroke who received regularly scheduled blood transfusions for a minimum of 5 years was conducted. Medical records were examined for the documentation of antecedent or concurrent medical events (hypertension, acute chest syndrome, aplastic crisis, fever associated with infection, exchange transfusion) associated with physician contact within 14 days before the initial stroke. Results: A total of 137 pediatric patients from 14 centers were studied. Mean age at first stroke was 6.3 years (1.4 to 14.0 years) with mean follow-up of 10.1 years (5 to 24 years). Thirty-one (22%) patients had a second stroke (2.2 per 100 patient years); 26 patients had an identified medical or concurrent event associated with their initial stroke. None of these patients had recurrent stroke 2 or more years after the initial event. The remaining 111 patients had an ongoing risk of recurrent stroke (1.9 per 100 patient-years) despite long-term transfusions (P = .038). Conclusions: The absence of an antecedent or concurrent medical event associated with an initial stroke is a major risk factor for subsequent stroke while receiving regular transfusions.

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