Strauss David, Shavelle Robert, Reynolds Robert, Rosenbloom Lewis, Day Steven
Life Expectancy Project, San Francisco, CA 94122-3402, USA.
Dev Med Child Neurol. 2007 Feb;49(2):86-92. doi: 10.1111/j.1469-8749.2007.00086.x.
This study investigated the possibility of improved survival in cerebral palsy (CP) over a 20-year period. Participants were 47 259 persons with CP receiving services from the State of California between 1983 and 2002. The person-year approach was used. This asks whether the probability of dying in a given calendar year changes over the study period after age and severity of disability are taken into account. An appreciable improvement over time was found in children with severe disabilities and in adults who required gastrostomy feeding. In these groups, mortality rates fell by 3.4% per year. Therefore, life expectancies reported in earlier studies should be increased by approximately 5 years if adjustments to 2002 mortality rates are made. For other persons with CP there was, at most, a small improvement over the 20-year period. The results suggest there have been improvements in the treatment and care of the most medically fragile children. Gastrostomy feeding has become much more widespread over the past two decades, and the improved survival of persons with gastrostomies may reflect better understanding of their requirements.
本研究调查了20年间脑瘫（CP）患者生存率提高的可能性。研究对象为1983年至2002年间在加利福尼亚州接受服务的47259名脑瘫患者。采用人年法。该方法探讨了在考虑年龄和残疾严重程度后，特定日历年度内的死亡概率在研究期间是否发生变化。研究发现，严重残疾儿童和需要胃造口喂养的成年人的生存率随时间有显著提高。在这些群体中，死亡率每年下降3.4%。因此，如果根据2002年的死亡率进行调整，早期研究报告的预期寿命应增加约5年。对于其他脑瘫患者，在这20年期间最多只有小幅改善。结果表明，医学上最脆弱儿童的治疗和护理有所改善。在过去二十年中，胃造口喂养已更为普遍，胃造口患者生存率的提高可能反映出对其需求有了更好的了解。
