Article

AIM: To compare the prevalence of gastrostomy tube feeding (GTF) of children with
cerebral palsy (CP) in six European countries. METHOD: Data on 1295 children (754
males, 541 females ; mean age 5y 11mo, range 11y 2mo, min 6mo, max 11y 8mo) with
CP born from 1999 to 2001 were collected from geographically defined areas in six
European countries; four of the areas covered the whole country. Distribution of
CP was unilateral 37%, bilateral 51%, dyskinetic 8%, and ataxic 4%. Sixty children were classified in Gross Motor Function Classification System (GMFCS)
levels I and II, 6 in level III and 34 in levels IV and Vas Outcome measures were
GTF, age at placement, feeding difficulties and the children's height and weight
for age standard deviation scores (z-scores). RESULTS:
The use of GTF among all
children with CP was highest in western Sweden (22%, 95% confidence interval [CI]
16-29), and lowest in Portugal (6%, 95% CI 3-10), northern England (6%, 95% CI
3-9) and in Iceland (3%, 95% CI 0-13; p<0.001). The difference between areas was
greater among children in GMFCS levels IV and V (non-ambulant); in this group,
lower height z-scores were more prevalent in the areas with lower prevalence of
GTF. The children's age at placement of gastrostomy also varied between areas
(p<0.002). INTERPRETATION: The observed differences in the use of GTF may reflect
differences in access to treatment or clinical practice, or both. Our results
suggest that the use of GTF may improve growth in height and weight among
children with more severely affected gross motor function - the group most likely
to have associated feeding difficulties.
CI - (c) The Authors. Developmental Medicine & Child Neurology (c) 2012 Mac Keith
Press.

Langue : ANGLAIS