Article

This study used data collected prospectively since 1986 from a
population-based cerebral palsy registry to explore the rates, predictors,
trends, and causes of mortality for individuals born in Victoria, Australia,
between 1970 and 2004. METHOD: Data were extracted for 3507 individuals (1972
males; 1535 females). The probability of survival before 31 May 2010 was
determined using the Kaplan-Meier method; age-specific mortality rates were
calculated per 1000 person-years and related to population rates. Using Cox
proportional hazards regression, relative risks of mortality were estimated for
different categories of chosen demographic and clinical variables. Causes were
tabulated according to the direct cause of death. RESULTS: There were 418 deaths.
Crude mortality was 20% at the age of 40 years. Relative to the population,
mortality was highest in children aged under 15 years and decreased to twice the
population rate at the age of 35 years. The strongest independent predictor of
mortality was no independent ambulation (adjusted hazard ratio 6.2 [95%
confidence interval 3.3-11.8]); additional predictors were severe intellectual
impairment (3.0 [1.7-5.2]), epilepsy (1.4 [1.1-1.9]), deafness (2.6 [1.4-4.7]),
and term birth (1.8 [1.3-2.4]). No improvement in survival was seen over time
(unadjusted hazard ratio 1.00 [95% CI 0.99-1.01]). Respiratory causes were the
most common direct causes of death. INTERPRETATION: Rates, predictors, and causes
of death for individuals with cerebral palsy in Victoria were similar to those
found in other population cohorts. Lack of improvement in survival since 1970 was
an unexpected finding that warrants further investigation.
CI - (c) The Authors. Developmental Medicine & Child Neurology (c) 2012 Mac Keith
Press.

Langue : ANGLAIS