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Early Adulthood Outcomes Among Individuals With Neurologic Impairment and Technology Assistance

Jenna Doig1,2, Rayzel Shulman2,3,4,5,6, Eleanor Pullenayegum4,7

  • 1Division of Developmental Paediatrics, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada.

Pediatrics
|July 7, 2026
PubMed

Insights

Individuals with neurologic impairment and technology assistance (NI+TA) experienced fewer hospitalizations but similar emergency department visits in early adulthood. Mortality was significant, particularly for progressive conditions and multiple technology use.

Area of Science:

  • Pediatric Health Outcomes
  • Neurologic Impairment Research
  • Healthcare Utilization Studies

Background:

  • Individuals with neurologic impairment and technology assistance (NI+TA) have frequent healthcare interactions.
  • Limited data exists on the long-term health outcomes of NI+TA in early adulthood.

Purpose of the Study:

  • To describe acute care utilization (hospitalizations, emergency department visits) in young adults with NI+TA.
  • To determine mortality rates among individuals with NI+TA transitioning into adulthood.

Main Methods:

  • Population-based retrospective cohort study utilizing health administrative data.
  • Included individuals with childhood-onset NI+TA (enterostomy tubes, cerebrospinal fluid shunts, tracheostomies).
  • Analyzed outcomes from age 18 to 26, calculating event rates per 100 person-years and using Kaplan-Meier curves for mortality.

Main Results:

  • Hospitalizations decreased post-18 years (32.7/100PY) compared to baseline ages 16-17.
  • Emergency department visits remained similar (119.0/100PY) compared to baseline.
  • Mortality affected 14.4% of the cohort, with higher rates in progressive NI and multiple technology use.

Conclusions:

  • Acute care use in early adulthood showed a decrease in hospitalizations but stable ED visits for NI+TA.
  • Mortality is a significant concern in this population, especially with progressive neurologic conditions or multiple assistive technologies.
  • Further research is needed to understand and improve long-term outcomes for young adults with NI+TA.
Abstract

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