Survival with cerebral palsy over five decades in western Sweden
Survival with cerebral palsy over five decades in western Sweden
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DOI：
10.1111/dmcn.12718
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发表时间：
2015-08-01
影响因子：
3.8
通讯作者：
Sundh, Valter
中科院分区：
文献类型：
--
作者：
Himmelmann, Kate;Sundh, Valter
目的脑性瘫痪(CP)患者的预期寿命通常比一般人群要短。慢性胰腺炎患者长期存活的报道很少。这项研究的目的是调查五年来瑞典西部CP登记簿中记录的与CP类型和运动及伴随障碍有关的存活率和死亡原因。方法所有出生于1959至2002年的个体纳入研究。脑性瘫痪按Hagberg和欧洲脑性瘫痪监测(SCPE)进行分类。运动和伴随的损伤被记录下来。死因来自国家卫生和福利委员会，人口数据来自瑞典统计局。结果纳入研究的1856例脑性瘫痪患者(男1033例，女823例)，截至2009年12月31日死亡180例(9.6%)。四肢瘫痪、运动障碍、严重认知障碍和癫痫与存活率下降有关。在粗大运动功能分级系统(GMFCS)V级，痉挛型CP患者的存活率低于运动性CP患者。然而，与普通人群相比，所有年龄组和CP类型的CP患者的死亡率都较高。在所有年龄段，患有脑瘫的女性比男性有更大的额外死亡风险。呼吸衰竭导致了53%的死亡。对于偏瘫患者，就像在一般人群中一样，20%的死亡是意外的。解释存活率受CP类型的影响，但与没有CP的人相比，任何类型的CP患者的死亡风险都更高。
AimThe life expectancy of individuals with cerebral palsy (CP) is often reduced compared with the general population. Long-term survival with CP is rarely reported. The aim of this study was to investigate survival and the causes of death in relation to CP type and motor and accompanying impairments documented in the CP register of western Sweden over five decades.MethodAll individuals born between 1959 and 2002 were included in the study. CP was classified according to Hagberg and the Surveillance of Cerebral Palsy in Europe (SCPE). Motor and accompanying impairments were documented. Causes of death were derived from the National Board of Health and Welfare, and population data were obtained from Statistics Sweden. Log-rank tests with Kaplan-Meier plots were used for statistical analyses.ResultsOf the 1856 individuals (1033 males, 823 females) with CP included in the study, 180 (9.6%) had died by 31 December 2009. Tetraplegia, dyskinetic CP, severe cognitive impairment, and epilepsy were associated with decreased survival rates. At Gross Motor Function Classification System (GMFCS) level V, survival rates among individuals with spastic CP were lower than among those with dyskinetic CP. However, compared with the general population, there was an elevated death rate among individuals with CP for all age groups and CP types. At all ages, females with CP had a larger excess risk of death than males. Respiratory failure caused 53% of deaths. For individuals with hemiplegia, as in the general population, 20% of deaths were accidental.InterpretationSurvival rates are influenced by CP type but there is an elevated risk of death for individuals with any type of CP, compared with those without CP.