A national perspective of surgery in children with cerebral palsy.
A national perspective of surgery in children with cerebral palsy.
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脑瘫儿童手术的全国视角。
DOI：
10.1080/13638490500523283
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发表时间：
2006
期刊：
影响因子：
--
通讯作者：
Young,PaulC
中科院分区：
文献类型：
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作者：
Murphy,NancyA;Hoff,Charles;Jorgensen,Trisha;Norlin,Chuck;Firth,Sean;Young,PaulC
目的：患有脑瘫（CP）的儿童通常需要手术，但与没有CP的儿童相比，手术并发症的风险更高，结果更差。这项研究提供了一个国家的角度来看，儿童，医院和医院的过程与五个最常见的手术在儿童与CP和比较这种观点的儿童没有CP经历同样的procedures.Methods：分析1997年医疗成本和利用项目儿童住院数据库。在患有CP的儿童中进行的最常见手术（n= 37 000）为胃造口管置入（n= 1743）、软组织肌肉骨骼手术（n= 1393）、胃底折叠术（n= 1062），脊柱内固定融合术（n= 765）和髋关节骨性手术（n= 651）。在一九九七年，这五项手术合共占用近5万个住院日，而住院费用则超过1.5亿元。最大的差异，在儿童之间的结果与CP是在那些接受手术脊柱侧凸。结论：手术程序是经常在儿童CP。他们的成本和对美国医疗保健系统的影响是巨大的。这些发现提供了一个强烈的动机，仔细研究程序的好处，并制定干预措施，以改善结果，特别是在脊柱侧凸手术的情况下。
Purpose: Children with cerebral palsy (CP) often require surgery, but may be at higher risk for surgical complications and poorer outcomes than children without CP. This study provides a national perspective of the children, hospitals and hospital course associated with the five most commonly performed surgeries in children with CP and compares this perspective to that of children without CP undergoing the same procedures.Methods: Analysis of the 1997 Healthcare Cost and Utilization Project Kids’ Inpatient Database.Results: The most common surgeries performed in children with CP (n= 37 000) were gastrostomy tube placements (n= 1743), soft tissue musculoskeletal procedures (n= 1393), fundoplications (n= 1062), spinal fusions with instrumentation (n= 765) and bony hip surgeries (n= 651). Together, the five procedures accounted for nearly 50 000 hospital days and over $150 million in hospital charges in 1997. The largest difference in outcomes between children with and without CP was seen in those undergoing surgery for scoliosis.Conclusions: Surgical procedures are frequent in children with CP. Their costs and impact on the US health care system are substantial. The findings provide a strong incentive to carefully study the benefits of the procedures and to develop interventions to improve outcomes, particularly in the case of scoliosis surgery.