Hutton J L, Cooke T, Pharoah P O
Department of Statistics, University of Liverpool.
BMJ. 1994 Aug 13;309(6952):431-5. doi: 10.1136/bmj.309.6952.431.
To determine life expectancy of children with cerebral palsy.
Cohort analysis, by means of register compiled from multiple sources of ascertainment, of all children with cerebral palsy born during 1966-84 to mothers resident in Mersey region. Status of children was determined by flagging through NHS central register.
1258 subjects with idiopathic cerebral palsy, of whom 1251 were traced and included in analysis.
Effect of functional ability (ambulation, manual dexterity, and mental ability), sex, birth weight, and gestational age on survival.
20 year survival for whole cohort was 89.3% for females and 86.9% for males. For subjects with no severe functional disabilities 20 year survival was 99% (95% confidence interval 98% to 100%), while subjects severely disabled in all three functional groups had 20 year survival of 50% (42% to 58%). Subjects with birth weight < or = 2500 g had 20 year survival of 92% (89% to 95%), while those with birth weight > 2500 g had survival of 87% (84% to 89%). Subjects with gestational age of > 37 weeks had 20 year survival of 93% (91% to 96%), while those with gestational age > or = 37 weeks had survival of 85% (83% to 88%). Birth weight and gestational age were less predictive of survival than functional disability. Best statistical model used gestational age and number of severe functional disabilities as predictors.
Life expectancy of this cohort of children with cerebral palsy was greater than has been suggested in some previous studies. This has important implications for social, educational, and health services.
确定脑瘫患儿的预期寿命。
通过从多个确定来源汇编的登记册，对1966年至1984年期间在默西地区居住的母亲所生的所有脑瘫患儿进行队列分析。通过英国国家医疗服务体系中央登记册标记来确定儿童的状况。
1258例特发性脑瘫患儿，其中1251例被追踪并纳入分析。
功能能力（行走、手部灵活性和智力）、性别、出生体重和胎龄对生存的影响。
整个队列中女性20年生存率为89.3%，男性为86.9%。对于没有严重功能残疾的受试者，20年生存率为99%（95%置信区间为98%至100%），而在所有三个功能组中严重残疾的受试者20年生存率为50%（42%至58%）。出生体重≤2500g的受试者20年生存率为92%（89%至95%），而出生体重>2500g的受试者生存率为87%（84%至89%）。胎龄>37周的受试者20年生存率为93%（91%至96%），而胎龄≥37周的受试者生存率为85%（83%至88%）。出生体重和胎龄对生存的预测作用不如功能残疾。最佳统计模型使用胎龄和严重功能残疾数量作为预测指标。
这一队列脑瘫患儿的预期寿命比一些先前研究表明的要长。这对社会、教育和卫生服务具有重要意义。
