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Infections in childhood linked to high risk for ischemic stroke
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NEW ORLEANS — Common childhood infections appear to increase risk for ischemic stroke in children, according to research presented at the International Stroke Conference 2012.
Infection is an established risk factor for ischemic stroke in adults, and this study indicates the same is true for children. Researchers found acute infections are more important in triggering stroke than chronic infections over time.
Although upper respiratory tract infections were the most common, Heather Fullerton, MD, the study’s lead investigator, said that no single type of infection predominated.
“The infections we observed in children prior to stroke ran the gamut of common childhood infections: upper respiratory infections, other non-specific viral syndromes, otitis media, pharyngitis, urinary tract infections,” Fullerton, director of the Pediatric Stroke and Cerebrovascular Disease Center at the University of California in San Francisco, told Cardiology Today. “This suggests that there is no ‘stroke bug,’ but rather that the association with stroke is a non-specific effect of common infections, likely related to the inflammation that results from an infection.”
In a review of 2.5 million children, the researchers identified 126 childhood ischemic stroke cases and then randomly selected 378 age-matched controls from the remaining children without stroke. The investigators discovered that 29% of the patients who suffered a stroke had a medical encounter for infection in the 2 days preceding the stroke vs. 1% of controls (P<.0001) during the same time period.
In the 3- to 7-day window, 13% of children had an infection compared with 2% of controls (P<.0001), and there was no difference in findings between girls and boys or ethnic groups. The elevated risk for stroke did not persist after the first month of infection, according to study findings.
Researchers analyzed diagnostic and radiologic databases of children enrolled in the Kaiser Permanente Healthcare Plan from 1993 to 2007. The children with stroke ranged in age from infants to adolescents, with an average age of 10.5 years. Researchers identified three stroke-free controls per case. They evaluated medical records and chart reviews for infections during the 2 years before the childhood stroke, and the same time period for the age-matched controls.
The study findings hold implications for the secondary prevention of stroke in children, Fullerton said.
For more information:
- Fullerton H. Abstract 39. Presented at: the American Stroke Association’s International Stroke Conference 2012; Feb. 1-3, 2012; New Orleans.
Disclosure: The National Institute of Neurological Disorders and Stroke funded the study.