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Accepted (AM)Open Access (License Unspecified), Open
Journal article
Transcranial Doppler Ultrasonography and Prophylactic Transfusion Program Is Effective in Preventing Overt Stroke in Children with Sickle Cell Disease
The Journal of pediatrics, v 157(3), pp 479-484
01 Sep 2010
PMID: 20434165
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Objective To assess the impact of our transcranial Doppler ultrasonography (TCD) program on the incidence of first stroke and the rate of transfusion for stroke prevention in children with sickle cell disease.
Study design In this single-institution, retrospective study, we compared the incidence of stroke and of transfusion for stroke prevention in 475 patients observed in the 8-year period before instituting TCD screening with the rate in 530 children in the 8-year period after.
Results The incidence of overt stroke in the pre-TCD period was 0.67 per 100 patient-years, compared with 0.06 per 100 patient-years in the post-TCD period (P < .0001). Of the 2 strokes in the post-TCD period, 1 occurred in a child too young for the screening protocol, and 1 occurred in a child with high velocities solely in the anterior cerebral arteries. The rate of transfusion therapy for stroke prevention increased from 0.67 per 100 patient-years to 1.12 per 100 patient-years since instituting our program (P = .008).
Conclusions Our program has been successful in reducing the rate of first overt stroke, but with increased use of transfusion. Additional modifications to screening might further reduce the risk of first stroke, and studies of alternative treatments may be beneficial. (J Pediatr 2010; 157: 479-84).
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Details
- Title
- Transcranial Doppler Ultrasonography and Prophylactic Transfusion Program Is Effective in Preventing Overt Stroke in Children with Sickle Cell Disease
- Creators
- Henrietta Enninful-Eghan - Childrens Hosp Philadelphia, Div Hematol, Philadelphia, PA 19104 USARenee H. Moore - University of PennsylvaniaRebecca Ichord - Children's Hospital of PhiladelphiaKim Smith-Whitley - Childrens Hosp Philadelphia, Div Hematol, Philadelphia, PA 19104 USAJanet L. Kwiatkowski - University of Pennsylvania
- Publication Details
- The Journal of pediatrics, v 157(3), pp 479-484
- Publisher
- Elsevier
- Number of pages
- 6
- Grant note
- U01HL052016 / NATIONAL HEART, LUNG, AND BLOOD INSTITUTE; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Heart Lung & Blood Institute (NHLBI) U54 HL70596; U01 HL 052193; U01 HL 052016 / National Heart, Lung, and Blood Institute; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Heart Lung & Blood Institute (NHLBI)
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Epidemiology and Biostatistics
- Web of Science ID
- WOS:000281116100028
- Scopus ID
- 2-s2.0-77955985356
- Other Identifier
- 991021448175904721
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- Web of Science research areas
- Pediatrics