Comorbidities in cerebral palsy: a patient registry study

Abstract

NPR Norwegian Patient RegistryAIM To describe the total burden of disease in individuals with cerebral palsy (CP) in Norway.METHOD A comprehensive set of disorder categories were extracted from the Norwegian Patient Registry using International Statistical Classification of Diseases, 10th Revision diagnosis codes for individuals born between 1996 and 2010 who received specialist healthcare between 2008 and 2017 (0-21y). Individuals with CP were identified through a validation study in cooperation with the Cerebral Palsy Registry of Norway. Risk differences (proportions of individuals recorded with each disorder) were used to compare individuals with CP with the general population without CP. RESULTSThe study included 966 760 individuals. Among these, 2302 (0.24%) had CP (1330 males, 972 females). Of the individuals with CP, 95.0% were recorded with one or more comorbidity, and the risks of medical, neurological, and mental/behavioural disorders were higher compared with the risks in the general population. The most common neurological and mental/behavioural disorders were cocausal, i.e. attributed to the same injury to the developing brain that caused CP, while medical disorders were most often complications of CP or coincidentally co-occurring with CP.INTERPRETATION Individuals with CP have a considerably higher burden of medical, neurological, and mental/behavioural disorders compared with the general population, including disorders that are not directly caused by, or complications to, the brain injury. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. -5 0 5 10 15 20 25 30 35 40 45 Percentage of risk differences (99% CIs) Disorder category Risk difference (99% CI) Figure 1: Risk differences with 99% confidence intervals (CIs) comparing the occurrence of disorders between individuals with cerebral palsy and the general population born from 1996 to 2010. CNS, central nervous system; ADHD, attention-deficit/hyperactivity disorder. [Colour figure can be viewed at wileyonlinelibrary.com] Comorbidities in CP Sandra Julsen Hollung et al. 101

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“…Therefore, the use of growth charts for typicallydeveloping children to assess growth in children with NI is recommended [1]. Assessment of nutritional status in NI children should not be based on weight and height measurements alone, but should include the evaluation of body composition [1,9,10]. The three most commonly used measurements to calculate growth charts in typically-developing children, such as weight-to-height ratio, height for-age, and weight-for-age are poor predictors of body composition in this group of patients [1].…”

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