小児科と治療学
オープンアクセス

概要

Pediatric Cerebral Palsy Life Expectancy: Has Survival Improved Over Time?

Saugata Ray ,Shelly Chatterjee ,Pilar Ruiz-Lozano

Purpose: The management and treatment of cerebral palsy (CP) presents a challenge despite advancements in nutrition and feeding as well as the management of bronchopulmonary complications and disorders. Relative poorer survival has been observed among CP children and has been associated with intellectual and motor impairments as markers of disease severity and hence excess mortality. However it is unclear if the advancement in treatment parallels survival of these patients. This systematic review is aimed to examine whether or not survival has improved over time,
comparing before and after the year 2000.
Materials and methods: We utilized a systematic review design to search literature published between 1966 and 2012. The search terms used were “cerebral palsy and mortality”, “cerebral palsy and survival”, “cerebral palsy geography”, “cognitive impairment” and “motor impairment”. We identified 22 articles and performed a literature synthesis to address the research question.
Results: CP survival is influenced motor impairment, intellectual impairment, as well as other contributory factors such as low birth weight, socioeconomic status (SES) and gestational age. The causes of death remain largely respiratory issues and disorders. Survival among CP patients is significantly lower than those of children in the general population. It appears there is no significant difference in survival of CP patients over time despite improvement in treatment and a slight decline in mortality comparing studies published before 2000 with those after 2000.
Conclusions: Motor and intellectual impairment as two major contributing factors to CP survival among children. Additionally, respiratory disorders and issues remain a most significant factor in the causal pathway of CP mortality. Furthermore, the survival of children with CP has not significantly improved over time, despite advancements in respiratory and feeding and nutrition management. The finding in this systematic review is suggestive of aggressive management and treatment of respiratory problems in order to prolong survival of children with CP.