Retrospective outcomes after childhood stroke in an inpatient paediatric rehabilitation unit.

Abstract

Aim: Childhood stroke has an estimated incidence of 2-13 per 100 000 children. Limited consensus exists regarding best practice recommendations for childhood stroke rehabilitation. A retrospective study completed at a tertiary institution identified potential associations between factors including type of stroke, functional presentation, muscle strength and length of stay (LOS).

Methods: A retrospective study of children post-stroke admitted 2014-2019 evaluated factors influencing outcome within inpatient rehabilitation. Exploratory analyses were completed to investigate relationships between variables including LOS, functional change, premorbid comorbidities and muscle strength.

Results: Data on 42 episodes of care (42 children: 18 males) following stroke were sourced from 2014 to 2019. Descriptive statistics were calculated for patient demographics, stroke characteristics, surgical treatment, premorbid comorbidities and muscle strength. Differences in WeeFIM scores between admission and discharge from the inpatient rehabilitation unit were tested using paired t tests. A higher number of children sustained ischaemic stroke (AIS, n = 24) when compared with haemorrhagic stroke (HS, n = 16). The average proportion of rehabilitation LOS to total hospital stay across all stroke types was 54.5%. Assessment of function demonstrated significant improvement between admission and discharge scores across all WeeFIM domains. Presence of comorbidities across stroke survivors was correlated with lower functional levels at discharge despite similar rehabilitation LOS.

Conclusion: Limited consensus exists guiding paediatric rehabilitation post-childhood stroke. This paper provides preliminary data on a cohort post-childhood stroke at a tertiary-level inpatient service. Paediatric stroke survivors showed significant functional improvements after inpatient rehabilitation, with the self-care domain showing greater improvements than mobility and cognition domains, respectively.