Pediatric Acute Stroke Protocol Implementation and Utilization Over 7 Years

The Journal of Pediatrics
Jessica D WhartonLori C Jordan

Abstract

To examine the implementation and utilization of a pediatric acute stroke protocol over a 7-year period, hypothesizing improvements in protocol implementation and increased protocol use over time. Clinical and demographic data for this retrospective observational study from 2011 through 2018 were obtained from a quality improvement database and medical records of children for whom the acute stroke protocol was activated. The initial 43 months of the protocol (period 1) were compared with the subsequent 43 months (period 2). Over the 7-year period, a total of 385 stroke alerts were activated, in 150 children (39%) in period 1 and 235 (61%) in period 2, representing a 56% increase in protocol activation. Stroke was the final diagnosis in 80 children overall (21%), including 38 (25%) in period 1 and 42 (19%) in period 2 (P = .078). The combined frequency of diagnosed stroke, transient ischemic attack (TIA), and other neurologic emergencies remained stable across the 2 time periods at 39% and 37%, respectively (P = .745). Pediatric National Institutes of Health Stroke Scale (PedNIHSS) documentation increased from 42% in period 1 to 82% in period 2 (P < .001). Magnetic resonance imaging (MRI) was the first neuroimaging study for 68%...Continue Reading

Citations

Mar 12, 2021·Stroke; a Journal of Cerebral Circulation·David C LauzierAkash P Kansagra
Apr 9, 2021·Stroke; a Journal of Cerebral Circulation·Monique F Kilkenny, Dawn M Bravata
Jul 31, 2021·European Journal of Pediatrics·Mario MastrangeloVincenzo Leuzzi

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