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Predicting respiratory hospital admissions in young people with cerebral palsy
  1. Amanda Marie Blackmore1,
  2. Natasha Bear2,3,
  3. Eve Blair4,
  4. Katherine Langdon5,6,
  5. Lisa Moshovis1,
  6. Kellie Steer7,
  7. Andrew C Wilson4,6,8
  1. 1 Therapy and Health Services, Ability Centre, Mount Lawley, Western Australia, Australia
  2. 2 Physiotherapy, Princess Margaret Hospital for Children, Perth, Western Australia, Australia
  3. 3 Department of Clinical Research and Education, Child Adolescent Health Service, Subiaco, Western Australia, Australia
  4. 4 Telethon Kids Institute, The University of Western Australia, Subiaco, Western Australia, Australia
  5. 5 Paediatric Rehabilitation, Princess Margaret Hospital for Children, Subiaco, Western Australia, Australia
  6. 6 School of Paediatrics and Child Health, The University of Western Australia, Crawley, Western Australia, Australia
  7. 7 Organisational Effectiveness Unit, Ramsay Health Care, Joondalup, Western Australia, Australia
  8. 8 Respiratory Medicine, Princess Margaret Hospital for Children, Subiaco, Western Australia, Australia
  1. Correspondence to Dr Amanda Marie Blackmore, Therapy and Health Services, Ability Centre, Mount Lawley, WA 6929, Australia; marie.blackmore{at}abilitycentre.com.au

Abstract

Objective To determine the early predictors of respiratory hospital admissions in young people with cerebral palsy (CP).

Design A 3-year prospective cohort study using linked data.

Patients Children and young people with CP, aged 1 to 26 years.

Main outcome measures Self-reported and carer-reported respiratory symptoms were linked to respiratory hospital admissions (as defined by the International Statistical Classification of Diseases and Related Health Problems 10th Revision codes) during the following 3 years.

Results 482 participants (including 289 males) were recruited. They were aged 1 to 26 years (mean 10 years, 10 months; SD 5 years, 11 months) at the commencement of the study, and represented all Gross Motor Function Classification Scale (GMFCS) levels. During the 3-year period, 55 (11.4%) participants had a total of 186 respiratory hospital admissions, and spent a total of 1475 days in hospital. Statistically significant risk factors for subsequent respiratory hospital admissions over 3 years in univariate analyses were GMFCS level V, at least one respiratory hospital admission in the year preceding the survey, oropharyngeal dysphagia, seizures, frequent respiratory symptoms, gastro-oesophageal reflux disease, at least two courses of antibiotics in the year preceding the survey, mealtime respiratory symptoms and nightly snoring.

Conclusions Most risk factors for respiratory hospital admissions are potentially modifiable. Early identification of oropharyngeal dysphagia and the management of seizures may help prevent serious respiratory illness. One respiratory hospital admission should trigger further evaluation and management to prevent subsequent respiratory illness.

  • cerebral palsy
  • respiratory tract diseases
  • respiratory
  • deglutition
  • child

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/archdischild-2017-314346

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    Footnotes

    • Funding The initial survey was funded by Health Networks Funding from the Western Australian Health Department. Analysis of the linked data was funded by individual donations to the Ability Centre and by Non-Government Centre Support.

    • Competing interests None declared.

    • Ethics approval Princess Margaret Hospital for Children Ethics Committee and the Department of Health Western Australian Human Research Ethics Committee.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement Additional unpublished data from the study are not available.

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