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Hospitalizations in School-Aged Children with Cerebral Palsy and Population-Based Controls
Olivier Fortin1, Pamela Ng2, Marc Dorais3
1Departments of Pediatrics and Neurology & Neurosurgery, McGill University, Montréal, QC, Canada.
Insights
Children with cerebral palsy (CP) experience more frequent and longer hospitalizations than healthy children. Factors like feeding difficulties and cognitive impairment increase hospitalization risk in CP patients.
Area of Science:
- Pediatric Health
- Neurology
- Public Health
Background:
- Cerebral palsy (CP) is a complex neurological disorder affecting motor function.
- Understanding hospitalization patterns in children with CP is crucial for resource allocation and care planning.
Purpose of the Study:
- To compare hospitalization rates between children with CP and healthy controls.
- To identify specific factors associated with increased hospitalizations in children with CP.
Main Methods:
- Retrospective cohort study linking provincial CP Registry data with administrative health databases.
- Matched comparison of 301 children with CP (born 1999-2002) to 6040 controls.
- Statistical analysis included mean differences and relative risk (RR) calculations.
Main Results:
- Children with CP had significantly higher mean hospitalizations (5.0 per child), longer stays (2.8 days), and more diagnoses per stay (1.6) than controls.
- Non-ambulant children and those with spastic tri/quadriplegic CP faced increased hospitalization risks.
- Feeding difficulties, cortical visual impairment, cognitive impairment, and communication issues were associated with higher hospitalization rates.
Conclusions:
- Children with CP, particularly those with severe profiles, require more frequent and extended hospital care.
- There is a need for coordinated, interdisciplinary care for school-aged children with CP and complex medical needs.
Objective:
To compare hospitalizations among children with cerebral palsy (CP) and healthy controls and to identify factors associated with hospitalizations in children with CP.
Methods:
This retrospective cohort study linked data from a provincial CP Registry and administrative health databases. The CP cohort was comprised of children born from 1999 to 2002. Age, sex, and region-matched controls were identified from administrative health databases. Mean differences, relative risk (RR), and 95% confidence intervals (CIs) were calculated.
Results:
A total of 301 children with CP were linked to administrative health data and matched to 6040 controls. Mean hospitalizations per child during the study period were higher in children with CP compared to controls (raw mean difference (RMD) 5.0 95% CI 4.7 to 5.2) with longer length of stay (RMD 2.8 95% CI 1.8 to 3.8) and number of diagnoses per hospitalization (RMD 1.6 95% CI 1.4 to 1.8). Increased risk of hospitalization was observed in non-ambulant children with CP (RR 1.12 95% CI 1.01 to 1.22) compared to ambulant children and among those with spastic tri/quadriplegic CP compared to other CP subtypes (RR 1.15, 95% CI 1.05 to 1.27). Feeding difficulties (RR 1.20 95% CI 1.13 to 1.27), cortical visual (RR 1.22 95% CI 1.13 to 1.32), cognitive (RR 1.16 95% CI 1.04 to 1.30), and communication impairment (RR 1.26 95% CI 1.10 to 1.44) were associated with increased hospitalizations.
Conclusions:
Children with CP face more frequent, longer hospital stays than peers, especially those with a more severe CP profile. Coordinated interdisciplinary care is needed in school-aged children with CP and medical complexity.
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