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Blood, 15 July 2004, Vol. 104, No. 2, pp. 336-339.
Prepublished online as a Blood First Edition Paper on March 30, 2004; DOI 10.1182/blood-2004-02-0636.
 Previous Article | Next Article 
Submitted February 19, 2004
Accepted March 11, 2004
Declining Stroke Rates in Californian Children with Sickle Cell Disease
Heather J Fullerton*, Robert J Adams, Shoujun Zhao, and S C Johnston
Neurology, Pediatrics, Epidemiology, University of California, San Francisco, CA, USA
Neurology, Medical College of Georgia, Augusta, Augusta, GA, USA
* Corresponding author; email: hjfc{at}itsa.ucsf.edu.
Although the Stroke Prevention Trial in Sickle Cell Anemia (STOP) demonstrated the efficacy of blood transfusions for primary stroke prevention in high-risk children with sickle cell disease in 1998, the impact of this trial on public health has not been studied. Our objective was to determine whether stroke rates in Californian children with sickle cell disease have declined since 1998. Using a California-wide hospital discharge database, we identified all first admissions for stroke in children with sickle cell disease from 1991 through 2000. Annual stroke incidence rates were calculated as the number of admissions divided by the estimated population of Californian children with sickle cell disease in that year. From 1991-2000, 93 children with sickle cell disease were admitted to Californian hospitals with a first stroke during 12,030 person-years of follow-up; 92.5% were ischemic, 7.5% hemorrhagic. Overall, the rate of first stroke was 0.77 per 100 person-years. For the study years 1991-1998, the first-stroke rate was 0.88 per 100 person-years, compared to 0.50 in 1999 and 0.17 in 2000 (p<0.005 for trend). Since the publication of the STOP study in 1998, annual rates of first-stroke admissions for Californian children with sickle cell disease have declined.
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