Survival and mortality in cerebral palsy: observations to the sixth decade from a data linkage study of a total population register and National Death Index
Survival and mortality in cerebral palsy: observations to the sixth decade from a data linkage study of a total population register and National Death Index
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DOI：
10.1186/s12883-019-1343-1
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发表时间：
2019-06-04
期刊：
影响因子：
2.6
通讯作者：
Watson, Linda
中科院分区：
文献类型：
--
作者：
Blair, Eve;Langdon, Katherine;Watson, Linda
脑瘫患儿的生存时间对脑瘫患者、他们的家庭、护理人员、卫生专业人员、卫生经济学家和保险公司来说是非常重要的。本文的目的是描述生存和死亡率的模式，以第六个十年在地理上定义的人口与脑瘫分层根据临床描述，他们的障碍，在幼儿期。MethodsIdentifiers的人出生在西澳大利亚州1956-2011年，登记与脑瘫的西澳大利亚州登记发育异常和生存至少12个月，与2014年12月的澳大利亚国家死亡指数有关。死亡率的模式进行了调查，使用生存分析methods.ResultsOf 3185符合条件的人，436（13.7%）已经死亡。在该样本中，22%的轻度损伤患者的生存模式与一般人群相似。死亡率随着损伤严重程度的增加而增加。在349例（75%）有死亡原因数据的患者中，58.6%归因于呼吸道原因，包括171例（49%）肺炎，平均年龄为14.6岁（标准差13.4）年，其中77年（45%）归因于吸气。对于最严重的受损，从1950年代到1990年，出生队列中的幼儿死亡率在随后的几十年中有所增加，在1981-1990年出生队列中，20%的人在40岁之前死亡;随后，出生队列的死亡率下降，直到15岁才达到20%。然而，20岁的死亡率最严重受损的出生在1991-2000年的出生队列超过了所有其他的出生cohols.Remaining预期寿命由年龄到50 years的估计两个阶层更严重immortations.ConclusionFor 22%的个人与脑瘫轻度损伤生存到58年是类似的一般人群。自1990年以来，西澳大利亚州严重脑瘫患者的死亡率趋于从儿童期转移到成年早期。
BackgroundLikely duration of survival of children described as having cerebral palsy is of considerable interest to individuals with cerebral palsy, their families, carers, health professionals, health economists and insurers. The aim of this paper is to describe patterns of survival and mortality to the sixth decade in a geographically defined population of people with cerebral palsy stratified according to the clinical description of their impairments in early childhood.MethodsIdentifiers of persons born in Western Australia 1956-2011, registered with cerebral palsy on the Western Australian Register of Developmental Anomalies and surviving at least 12months, were linked to the Australian National Death Index in December 2014. Patterns of mortality were investigated using survival analysis methods.ResultsOf 3185 eligible persons, 436 (13.7%) had died. Of that sample the 22% with the mildest impairment had survival patterns similar to the general population. Mortality increased with increasing severity of impairment. Of 349 (75%) with available cause of death data, 58.6% were attributed to respiratory causes, including 171 (49%) to pneumonia at a mean age of 14.6 (sd 13.4) years of which 77 (45%) were attributed to aspiration.For the most severely impaired, early childhood mortality increased in succeeding decades of birth cohorts from 1950s to 1990 with 20% dying by 4years of age in the 1981-1990 birth cohort; it then decreased for subsequent birth cohorts, 20% mortality not being attained until 15years of age. However by 20years of age mortality of the most severely impaired born in the 1991-2000 birth cohort exceeded that of all other birth cohorts.Remaining life expectancies by age to 50years have been estimated for two strata with more severe impairments.ConclusionFor 22% of individuals with cerebral palsy with mild impairment survival to 58years is similar to that of the general population. Since 1990 mortality for those with severe cerebral palsy in Western Australia has tended to shift from childhood to early adulthood.