Paediatric stroke care and outcomes: Insights from the Australian Stroke Clinical Registry

Abstract

Background/aims: The Australian Stroke Clinical Registry (AuSCR) supports improvements to the quality of acute stroke care, irrespective of age or type of admitting hospital (paediatric or adult). We aimed to examine the care by admitting hospital (paediatric or adult) and outcomes received by paediatric patients with acute stroke. Methods: Data were analysed from AuSCR hospitals (2018-2023) for patients aged <18 years. Eligible registrants/proxies (usually parents) were invited to complete an outcome survey between 90-180 days from admission. This included an age-specific quality-of-life survey (PedsQL; 0-100 [best health]). Descriptive analyses were presented by age-group and admitting hospital. Results: There were 258 paediatric episodes (45% female, 49% 0-4 years, 83% ischaemic). Children aged <12 years (vs 12-17 years) were more often treated in paediatric hospitals (64%, 47% from one Victorian hospital); those admitted to adult (vs paediatric) hospitals were more likely to be provided thrombectomy (11/29 [37%] vs 5/61 [8%]; P≤0.001), but there was no significant difference in thrombolytic therapy provision (5/43 [12%] vs 5/93 [5%]; P=0.14). Most (13/16) thrombectomies occurred in patients aged 13-17 years. Median length of stay was longer among those treated in paediatric hospitals versus adult hospitals (17 [IQR 27] days vs 3 [IQR 9] days; P≤0.001). Among 123 respondents to the PedsQL, the mean total score was 71/100 [SD 19], with differences by age group. Psychosocial health scores were lowest in 8-12 year-olds (mean=67). Conclusion: We provide novel insights on Australian treatment trends by admitting hospitals for children with stroke and their outcomes, including psychosocial health.