BACKGROUND Poor socioeconomic and health-related quality of life (HRQOL) outcomes in survivors of childhood cancer can lead to distress and overall negatively impact the lives of these individuals. The current report has highlighted the impact of stroke and stroke recurrence on mortality, psychological HRQOL, and socioeconomic outcomes within the Childhood Cancer Survivor Study (CCSS). METHODS The CCSS is a retrospective cohort study with longitudinal follow-up concerning survivors of pediatric cancer who were diagnosed between 1970 and 1986. Mortality rates per 100 person-years were calculated across 3 periods: 1) prior to stroke; 2) after first stroke and before recurrent stroke; and 3) after recurrent stroke. Socioeconomic outcomes, the standardized Brief Symptoms Inventory-18, the Medical Outcomes Study 36-Item Short Form Health Survey, and the CCSS-Neurocognitive Questionnaire also were assessed. RESULTS Among 14,358 participants (median age, 39.7 years), 224 had a stroke after their cancer diagnosis (single stroke in 161 patients and recurrent stroke in 63 patients). Based on 2636 deaths, all-cause late mortality rates were 0.70 (95% CI, 0.68-0.73) prior to stroke, 1.03 (95% CI, 0.73-1.46) after the first stroke, and 2.42 (95% CI, 1.48-3.94) after the recurrent stroke. Among 7304 survivors, those with stroke were more likely to live with a caregiver (single stroke odds ratio [OR], 2.3 [95% CI, 1.4-3.8]; and recurrent stroke OR, 5.3 [95% CI, 1.7-16.8]) compared with stroke-free survivors. Stroke negatively impacted task efficiency (single stroke OR, 2.4 [95% CI, 1.4-4.1] and recurrent stroke OR, 3.3 [95% CI, 1.1-10.3]) and memory (single stroke OR, 2.1 [95% CI, 1.2-3.7]; and recurrent stroke OR, 3.5 [95% CI, 1.1-10.5]). CONCLUSIONS Stroke and stroke recurrence are associated with increased mortality and negatively impact HRQOL measures in survivors of pediatric cancer.

中文翻译：

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在儿童癌症幸存者研究中，卒中对死亡率和心理发病率的影响。

背景技术儿童癌症幸存者中与社会经济和健康有关的生活质量（HRQOL）不良结果可能导致痛苦，并总体上不利于这些人的生活。本报告在儿童癌症幸存者研究（CCSS）中强调了中风和中风复发对死亡率，心理HRQOL和社会经济成果的影响。方法CCSS是一项回顾性队列研究，对1970年至1986年之间诊断出的小儿癌症幸存者进行了纵向随访。2）第一次中风后和复发性中风之前；3）复发性中风后。社会经济结果，标准化的简短症状清单18，医学成果研究36项简短健康调查，并评估了CCSS-神经认知问卷。结果在14,358名参与者（中位年龄为39.7岁）中，有224名在诊断出癌症后中风（单发中风161例，复发性中风63例）。基于2636例死亡，全因晚期死亡率为卒中前0.70（95％CI，0.68-0.73），第一次卒中后1.03（95％CI，0.73-1.46）和2.42（95％CI，1.48- 3.94）。在7304名幸存者中，患有中风的患者更有可能与照料者一起生活（单一中风比值比[OR]为2.3 [95％CI，1.4-3.8]；复发性中风OR为5.3 [95％CI，1.7-6.8] ）与没有中风的幸存者相比。中风对任务效率（单冲程OR，2.4 [95％CI，1.4-4.1]和复发性卒中OR，3.3 [95％CI，1.1-10.3]）和记忆（单冲程OR，2.1 [95％CI，1.2] -3.7]；和复发性卒中OR，3.5 [95％CI，1.1-10.5]。结论中风和中风复发与小儿癌症幸存者的死亡率增加和对HRQOL措施产生负面影响有关。