Life expectancy among people with cerebral palsy in Western Australia
Life expectancy among people with cerebral palsy in Western Australia
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DOI：
10.1017/s0012162201000949
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发表时间：
2001-08-01
影响因子：
3.8
通讯作者：
Stanley, FJ
中科院分区：
文献类型：
--
作者：
Blair, E;Watson, L;Stanley, FJ
本报告描述了脑瘫 (CP) 患者死亡的趋势、预测因素和原因，使用了西澳大利亚州脑瘫登记册确定的 1958 年至 1994 年间出生的个体。确定了 2014 人（1154 名男性，860 名女性），其中 225 人截至 1997 年 6 月 1 日死亡。使用死亡日期数据，估计了粗略和标准化死亡率，并使用生存率寻求死亡率的预测因素按出生十年、损伤描述以及人口和围产期变量进行分层分析。对于 1967 年之后出生的人，我们会随着时间的推移对死因进行检查。死亡率每年超过 1%。前5年下降到15岁，之后20年稳定在0.35%左右。最有力的单一预测因素是智力障碍，但所有形式的残疾都会导致预期寿命下降。 IQ/DQ 分数 < 20 的人中有一半存活到成年，IQ/DQ 分数为 20-34 的人存活到成年的比例增加到 76%，IQ/DQ 分数更高的人存活到成年的比例超过 92%。严重的运动障碍主要增加早期死亡的风险。尽管我们的数据集中有 72 名年龄在 25 岁至 41 岁之间的人患有严重的运动障碍，但没有人在 25 岁之后死亡。妊娠超过 32 周后出生的婴儿的死亡风险明显高于早产儿，这是因为他们的智力残疾率较高。尽管医疗保健取得了进步，社区意识有所提高，并且脑瘫患者中早产的比例不断增加，但在研究期间，脑瘫患者的生存率并未得到改善。这可能是由于新生儿护理的改善使得残疾日益严重的婴儿得以生存。
This report describes trends, predictors, and causes of mortality in persons with cerebral palsy (CP) using individuals identified by the Western Australian Cerebral Palsy Register and born between 1958 and 1994. Two thousand and fourteen people were identified (1154 males, 860 females), of whom 225 had died by 1 June 1997. Using date-of-death data, crude and standardized mortality rates were estimated and predictors of mortality sought using survival analysis stratified by decade of birth, description of impairments, and demographic and perinatal variables. For those born after 1967, the cause of death profile was examined over time. Mortality exceeded 1% per annum. in the first 5 years and declined to age 15 years after which it remained steady at about 0.35% for the next 20 years. The strongest single predictor was intellectual disability, but all forms of disability contributed to decreased life expectancy. Half of those with IQ/DQ score < 20 survived to adulthood, increasing to 76% with IQ/DQ score 20-34, and exceeding 92% for higher scores. Severe motor impairment primarily increased the risk of early mortality. Despite there being 72 persons aged from 25 to 41 years with severe motor impairment in our data set, none had died after the age of 25 years. Infants born after more than 32 weeks' gestation were at significantly higher risk of mortality than very preterm infants, accounted for by their higher rates of intellectual disability. No improvements in survival of persons with CP were seen over the study period despite advances in medical care, improved community awareness, and the increasing proportion of very preterm births among people with CP. This may be the result of improved neonatal care enabling the survival of infants with increasingly severe disabilities.