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A national perspective of surgery in children with cerebral palsy
Nancy A Murphy1, Charles Hoff, Trisha Jorgensen
1Department of Pediatrics, University of Utah, Salt Lake City, UT 84132, USA. nancy.murphy@hsc.utah.edu
Insights
Children with cerebral palsy (CP) undergo frequent surgeries, incurring substantial healthcare costs. Scoliosis surgery showed the most significant outcome differences compared to children without CP, highlighting areas for improved interventions.
Area of Science:
- Pediatric Surgery
- Cerebral Palsy Research
- Healthcare Economics
Background:
- Children with cerebral palsy (CP) face higher surgical risks and poorer outcomes.
- Understanding the national surgical landscape for these children is crucial.
Purpose of the Study:
- To analyze the five most common surgeries in children with CP.
- To compare surgical outcomes and hospital courses between children with and without CP.
- To assess the national impact of these procedures on the healthcare system.
Main Methods:
- Analysis of the 1997 Healthcare Cost and Utilization Project Kids' Inpatient Database.
- Identification of the five most frequent surgical procedures in children with CP.
- Comparative analysis of outcomes for children with and without CP.
Main Results:
- The most common surgeries included gastrostomy tubes, soft tissue musculoskeletal procedures, fundoplications, spinal fusions, and hip surgeries.
- These five procedures accounted for nearly 50,000 hospital days and over $150 million in charges in 1997.
- Scoliosis surgery demonstrated the most pronounced outcome disparities between children with and without CP.
Conclusions:
- Surgical interventions are common in children with CP, with significant healthcare costs.
- Findings emphasize the need for further research into surgical benefits and outcome improvement strategies.
- Scoliosis surgery warrants particular attention for developing targeted interventions.
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 dollars 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.
