Survival Prognosis of Japanese With Severe Motor and Intellectual Disabilities Living in Public and Private Institutions Between 1961 and 2003

Abstract

BackgroundAlthough the prognosis for survival in people with severe functional disabilities is a serious concern for their families and health care practitioners, there have been few reports on survival rates for this population. Every year, the Japanese Association of Welfare for Persons with Severe Motor and Intellectual Disability collects anonymous records of individual registrations and deaths from all private and public institutions, excepting national institutions. We used these data to estimate the prognosis for survival.MethodsWe reviewed the records of 3221 people with severe motor and intellectual disabilities (SMID); all subjects had lived in one of 119 public or private institutions in Japan between 1961 and 2003. Kaplan–Meier survival estimates were calculated according to disability type and birth year range.ResultsOf the 3221 persons, 2645 were alive and 576 had died. The survival rate at the age of 20 for all subjects was 79% (95% confidence interval, 78%–81%). Among people who were unable to sit, those with lower intelligence quotients had lower survival rates.ConclusionsThe survival rate among people with SMID housed in public and private institutions in Japan was much worse than that of the general population, and has not improved since the 1960s.

The utility of biomarkers in differentiating bacterial from non-bacterial lower respiratory tract infection in hospitalized children: Difference of the diagnostic performance between acute pneumonia and bronchitis

“…In addition, the patients are susceptible to recurrent and chronic respiratory infections, which may damage the alveolar tissues. Based on their chronic respiratory condition, these children are susceptible to severe CA-LRTI, and early appropriate treatment is needed [20]. The present study indicated that the diagnostic performance of neutrophil counts might be superior to that of PCT and CRP in the differentiation of bacterial bronchitis.…”

“…Our hospital is a tertiary referral hospital in Fukuoka area, in which many patients with various underlying diseases are admitted for infectious diseases. The proportion of the patients with severe motor and intellectual disabilities (SMID), defined as combination of severe physical handicap and intellectual disability [20], was high in the children hospitalized for CA-LRTI. Children with SMID generally have obstructive and restrictive respiratory disorders making it difficult to clear out sputum from airways [20,21].…”

“…The proportion of the patients with severe motor and intellectual disabilities (SMID), defined as combination of severe physical handicap and intellectual disability [20], was high in the children hospitalized for CA-LRTI. Children with SMID generally have obstructive and restrictive respiratory disorders making it difficult to clear out sputum from airways [20,21]. In addition, the patients are susceptible to recurrent and chronic respiratory infections, which may damage the alveolar tissues.…”

Phase-locked theta activity evoked in patients with severe motor and intellectual disabilities upon hearing own names

“…Patients with SMID have a markedly low intelligence quotient (IQ), making it difficult for them to communicate verbally with their families and healthcare professionals [2]. Caregivers can thus encounter problems understanding patient responses or gaining their attention.…”

Difference between Japanese Secondary and Tertiary Medical Facilities Regarding Changes in the Hospitalization of Children for Pneumonia after the Introduction of the Pneumococcal Conjugate Vaccine

“…In our tertiary medical facility, many patients with severely impaired mobility, such as those with a chromosomal abnormality, cerebral palsy, sequela of hypoxic encephalopathy, and neuromuscular diseases, were hospitalized for pneumonia (Table 1). These patients generally have obstructive and restrictive respiratory disorders, making it difficult to clear out sputum from airways (13,14), and are prone to develop lower respiratory tract infection due to oral bacteria (15). In the patients hospitalized at our tertiary medical facility for pneumonia, the proportion of patients without underlying diseases was higher in children aged < 2 years, and the number of the hospitalizations for pneumonia other than confirmed viral or mycoplasmal pneumonia in this age group decreased after the implementation of official financial support for PCV vaccination.…”