Survival Rates Among Children With Severe Neurologic Disabilities

Plioplys, Audrius V.; Kasnicka, Irene; Lewis, Shelley; Moller, Debbie

doi:10.1097/00007611-199802000-00009

Cited by 79 publications

(57 citation statements)

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“…Some of these variables, such as ambulatory and cognitive ability, which were not found to be significant predictors for survival, are heavily influenced by the very small numbers of ambulatory children and the very few individuals with high level cognitive function in our study group. Based on previous studies (Evans et al 1990;Crichton et al 1995;Eyman et al 1990Eyman et al , 1993Hutton et al 1994Hutton et al , 2000Plioplys et al 1998;Strauss et al 1998), large populations that include more high-functioning individuals demonstrate these as significant factors. However, few of these less involved patients develop severe scoliosis.…”

Section: Resultsmentioning

confidence: 96%

“…Previous epidemiological studies had reported a relatively high mortality rate among patients with CP compared with that of the general population (Eyman et al 1990(Eyman et al , 1993. However, more recent studies have documented substantially better survival rates, clearly demonstrating that with the intense current medical support provided by the modern health systems, CP should be considered a disease with which one lives in contrast to the old belief that it is a condition from which one dies (Evans et al 1990;Hutton et al 1994Hutton et al , 2000Plioplys et al 1998). Kudrjavcev et al (1985) reported on a group of 64 children with CP up to 10 years of age who showed a 10% mortality rate within the first 10 years of life, with all of the patients who died having severe disabilities.…”

Section: Resultsmentioning

confidence: 99%

“…Crichton et al (1995) analyzed the data from the CP registry in British Columbia, Canada, and reported a mean 30-year survival rate of at least 87%, varying from 95% in patients with hemiplegia or monoplegia to 83.5% in those with quadriplegia having the worst prognosis. The most significant determinants for reduced life expectancy in pediatric patients with CP are the coexistence of other significant disorders such as respiratory malfunction, epilepsy, feeding disorders (particularly in patients requiring gastrostomy or nasogastric tube feedings), the degree of neurological involvement, the presence of severe cognitive abnormality, and the level of ambulatory disability (Evans et al 1990;Eyman et al 1990Eyman et al , 1993Hutton et al 1994Hutton et al , 2000Crichton et al 1995;Anderson 1996;Plioplys et al 1998;Strauss et al 1998). Respiratory disease, especially pulmonary infection, seems to be the predominant cause of death, specifically among individuals with mental retardation (Tarjan et al 1968, Chaney et al 1979, Eyman et al 1990).…”

Section: Resultsmentioning

confidence: 99%

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Life expectancy in pediatric patients with cerebral palsy and neuromuscular scoliosis who underwent spinal fusion

Chang

Dabney

Miller

et al. 2003

Develop Med Child Neuro

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The aim of this study was to document the rate of survival among 288 severely affected pediatric patients (154 females, 134 males) with spasticity and neuromuscular scoliosis who underwent spinal fusion (mean age at surgery 13 years 11 months, SD 3 years 4 months), and to identify exposure variables that could significantly predict survival times. Kaplan‐Meier survival analysis was performed demonstrating a mean predicted survival of 11 years 2 months after spinal surgery for this group of globally involved children with cerebral palsy (CP). Cox's proportional hazards model was used to evaluate predictive efficacy of exposure variables, such as sex, age at surgery, level of ambulation, cognitive ability, degree of coronal and sagittal plane spinal deformity, intraoperative blood loss, surgical time, days in hospital, and days in the intensive care unit. Number of days in intensive care unit after surgery and the presence of severe preoperative thoracic hyperkyphosis were the only factors affecting survival rates. This demonstrated statistically significant predictability for decreased life expectancy after spinal fusion in children with CP.

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Section: Resultsmentioning

confidence: 96%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Life expectancy in pediatric patients with cerebral palsy and neuromuscular scoliosis who underwent spinal fusion

Chang

Dabney

Miller

et al. 2003

Develop Med Child Neuro

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“…Eyman 2) asserted that the disabled who suffer mental retardation will, if they are immobile and require tube feeding, have an extremely short life expectancy, and most of them will die of respiratory insufficiency. Plioplys 3) also pointed out that of the cause of death for severely disabled children was pneumonia in 77% of cases. Fitzgerald 4) mentioned pulmonary aspiration, impaired mucociliary c l e a r a n c e , r e c u r r e n t i n f e c t i o n l e a d i n g t o bronchiectasis, kyphoscoliosis, upper airway obstruction, and lower airway obstruction as factors promoting lung diseases in cerebral palsy sufferers.…”

Section: Introductionmentioning

confidence: 99%

Ventilatory Effects of Manual Breathing Assist Technique (MBAT) and Shaking in Central Nervous System Disease Sufferers

et al. 2010

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Abstract. [Purpose] This research was carried out to evaluate the effects of Manual Breathing Assist Technique (MBAT) and shaking on the ventilation of central nervous system (CNS) disease patients.[Subjects and Methods] The subjects were thirteen healthy individuals (normal group) and twenty-one CNS diseases sufferers without upper airway obstruction (subject group). We evaluates of Tidal Volume (TV), Peak Expiratory Flow Rate (PEFR) and Expiratory Time (Te) under rest respiration, MBAT, and shaking conditions. Administration of MBAT and shaking was performed by a single physiotherapist.[Results] Two-way factorial analysis of variance showed a significant interaction effect for TV between the subject group and the normal group, while PEFR showed no significant interaction. TV of the normal group was increased about 65% by MBAT and about 110% by shaking, compared to TV under rest respiration. While TV of the subject group was increased about 10% by MBAT, no increase was observed under the condition of shaking.[Conclusion] Significant differences in TV and Te were observed between the subject group and normal group in terms of the effects of MBAT as well as shaking. Both MBAT and shaking were effective methods for increasing PEFR.

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“…Two studies, one also based on the Californian data set (Eyman et al 1993) and one from Chicago (Plioplys et al 1998) have considered survival with extremely severe disability. They are of considerable interest for the prognosis of children with similar disabilities, but include only the most severe forms of multiple disabilities and cannot be considered to represent the majority of persons with CP.…”

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confidence: 99%

Life expectancy among people with cerebral palsy in Western Australia

Blair

Watson

Badawi

et al. 2001

Develop Med Child Neuro

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This report describes trends, predictors, and causes of mortality in persons with cerebral palsy (CP)using individuals identified by the Western Australian Cerebral Palsy Register and born between 1958 and 1994. Two thousand and fourteen people were identified (1154 males, 860 females), of whom 225 had died by 1 June 1997. Using date-of-death data, crude and standardized mortality rates were estimated and predictors of mortality sought using survival analysis stratified by decade of birth, description of impairments, and demographic and perinatal variables. For those born after 1967, the cause of death profile was examined over time. Mortality exceeded 1% per annum in the first 5 years and declined to age 15 years after which it remained steady at about 0.35% for the next 20 years. The strongest single predictor was intellectual disability, but all forms of disability contributed to decreased life expectancy. Half of those with IQ/DQ score <20 survived to adulthood, increasing to 76% with IQ/DQ score 20-34, and exceeding 92% for higher scores. Severe motor impairment primarily increased the risk of early mortality. Despite there being 72 persons aged from 25 to 41 years with severe motor impairment in our data set, none had died after the age of 25 years. Infants born after more than 32 weeks' gestation were at significantly higher risk of mortality than very preterm infants, accounted for by their higher rates of intellectual disability. No improvements in survival of persons with CP were seen over the study period despite advances in medical care, improved community awareness, and the increasing proportion of very preterm births among people with CP. This may be the result of improved neonatal care enabling the survival of infants with increasingly severe disabilities.

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Survival Rates Among Children With Severe Neurologic Disabilities

Cited by 79 publications

References 0 publications

Life expectancy in pediatric patients with cerebral palsy and neuromuscular scoliosis who underwent spinal fusion

Life expectancy in pediatric patients with cerebral palsy and neuromuscular scoliosis who underwent spinal fusion

Ventilatory Effects of Manual Breathing Assist Technique (MBAT) and Shaking in Central Nervous System Disease Sufferers

Life expectancy among people with cerebral palsy in Western Australia

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