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Comparative mortality in cerebral palsy patients in California, 1980-1996
R B Singer1, D Strauss, R Shavelle
1Dept. of Statistics, Univ. of California, Riverside 92521, USA.
Insights
Mortality rates for individuals with cerebral palsy (CP) vary by severity. Those with quadriplegia experience higher excess death rates compared to less severe CP cases, particularly in older age groups.
Area of Science:
- Neurology
- Public Health
- Epidemiology
Background:
- Utilizes the California Department of Developmental Services database.
- Focuses on mortality rates in individuals diagnosed with cerebral palsy (CP).
- Examines data by age, sex, cause, and associated conditions.
Purpose of the Study:
- To analyze mortality rates in CP patients.
- To investigate the relationship between CP severity and mortality.
- To identify age- and sex-specific excess death rates.
Main Methods:
- Analysis of a large dataset from the California Department of Developmental Services.
- Stratification of CP patients into severity groups based on quadriplegia.
- Comparison of observed and expected mortality rates.
Main Results:
- Excess mortality was higher in CP patients with quadriplegia (16 per 1000) compared to less severe cases (6 per 1000).
- Mortality patterns differed by severity: less severe CP showed increased mortality with age, while quadriplegia had a dip in early adulthood before rising.
- Little difference in excess death rates was observed between sexes.
Conclusions:
- Quadriplegia is associated with significantly higher excess mortality in individuals with cerebral palsy.
- Age-related mortality trends in CP are influenced by disease severity.
- CP severity is a critical factor in understanding long-term survival and mortality patterns.
Background:
The large database of the California Department of Developmental Services provides a data source for mortality rates in persons with mental retardation by age, sex, severity, cause and associated conditions. This study involves patients with a diagnosis of cerebral palsy.
Results:
After a table of demographic data, four tables are used to show detailed age-related observed and expected mortality rates for Cerebral Palsy patients by sex and a severity factor that divides the patients into two groups of approximately equal size. The factor used was quadriplegia (all four limbs involved in motor dysfunction). Spasticity was the predominant feature of the motor dysfunction.
Conclusion:
Excess mortality was moderate in the less severe Cerebral Palsy patients, but was higher in those with quadriplegia (overall EDR--Excess Death Rate--about 6 per 1000 and 16 per 1000, respectively). In less severe cases EDR was higher at ages 1-4 years, the almost constant to age 49, then rose with advancing age. In case with quadriplegia EDR decreased in childhood and young adults to a relatively stable minimum at ages 25-49, then increased at older ages. There was little sex difference in EDR.