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Life expectancy of children with cerebral palsy
D J Strauss1, R M Shavelle, T W Anderson
1Department of Statistics; University of California; Riverside 92521, USA.
Insights
Functional mobility and feeding skills are key predictors of survival in young children with cerebral palsy (CP). Children with fair skills have good prognoses, while those lacking these abilities face significantly poorer survival.
Area of Science:
- Pediatrics
- Neurology
- Public Health
Background:
- Cerebral palsy (CP) affects motor function and can present with varying degrees of severity.
- Accurate prognostic factors for mortality in young children with CP are crucial for care planning and resource allocation.
Purpose of the Study:
- To identify key risk factors for mortality in young children diagnosed with cerebral palsy.
- To assess the predictive power of functional abilities versus other clinical indicators for survival.
Main Methods:
- Retrospective cohort study utilizing data from 12,709 children aged 0.5-3.5 years with CP in California (1980-1995).
- Analysis focused on functional items like mobility and feeding skills, alongside factors such as mental retardation and quadriplegia.
Main Results:
- Mobility and feeding skills were the strongest predictors of survival, overshadowing factors like mental retardation severity and quadriplegia.
- Children with fair motor and eating skills demonstrated high survival rates (≥90% to adulthood).
- For children unable to lift their heads, median survival was 7 years with tube feeding versus 14 years with other feeding methods.
Conclusions:
- Simple functional assessments (mobility, feeding) are powerful prognostic indicators for young children with CP.
- These functional skills significantly influence survival outcomes, more so than other clinical classifications.
- The findings support using functional status for more accurate survival predictions in pediatric CP cases.
Abstract:
Risk factors for mortality of young children with cerebral palsy were studied using a sample of 12,709 children aged 0.5-3.5 years with cerebral palsy who had received services from the State of California between 1980 and 1995. The most powerful prognostic factors for survival were simple functional items: mobility and feeding skills. Once these were known, factors such as severity of mental retardation and presence of quadriplegia contributed relatively little. Children with fair motor and eating skills had good survival prospects, with 90% or more reaching adulthood, but those without such skills had much poorer prospects. Among children who were unable to lift their heads, median survival time was 7 additional years for those who were tube fed (n = 557) and 14 years for those fed entirely by others (n = 997). Although a child's approximate survival chances can be assessed from such functional classifications, we indicate the manner in which additional information on the child's condition can be used to obtain more accurate survival data.