Prevalence and Risk Factors for Cerebral Palsy in Children With Congenital Heart Disease Based on Risk of Surgical Mortality.

Brain injury Cardiac surgery Disabilities Motor impairment Neurodevelopment Neurodevelopmental disabilities STAT

Journal

Pediatric neurology
ISSN: 1873-5150
Titre abrégé: Pediatr Neurol
Pays: United States
ID NLM: 8508183

Informations de publication

Date de publication:
01 Mar 2024
Historique:
received: 30 01 2023
revised: 20 12 2023
accepted: 26 02 2024
medline: 20 4 2024
pubmed: 20 4 2024
entrez: 19 4 2024
Statut: aheadofprint

Résumé

Children with congenital heart disease (CHD) have a higher prevalence of motor impairment secondary to brain injury, resulting in cerebral palsy (CP). The purpose of this study is to determine the prevalence of CP in CHD in a single-center cohort, stratify risk based on surgical mortality using Society of Thoracic Surgeons-European Association for Cardio-Thoracic Surgery (STAT) categories and identify risk factors. Retrospective cohort study of pediatric patients registered in the University of Florida (UF) Society of Thoracic Surgeons Congenital Heart Surgery database from 2006 to 2017 with a diagnosis of CHD who continued follow-up for more than two years at UF. A total of 701 children with CHD met inclusion criteria. Children identified to have CP were 54 (7.7%). Most common presentation was spastic hemiplegic CP with a Gross Motor Function Classification System of level 2. Analysis of surgical and intensive care factors between the two groups showed that children with CHD and CP had longer time from admission to surgery (P = 0.003), higher STAT categories 4 and 5 (P = 0.038), and higher frequency of brain injury and seizures (P < 0.001). Developmental disabilities and rehabilitation needs were significantly greater for children with CHD and CP when compared with those with CHD alone (P < 0.001). In our cohort, 7.7% children with CHD develop CP; this is significantly higher than the 2010 US population estimate of 0.3%. Our study suggests higher STAT categories, brain injury, and seizures are associated with developing CP in children with CHD.

Sections du résumé

BACKGROUND BACKGROUND
Children with congenital heart disease (CHD) have a higher prevalence of motor impairment secondary to brain injury, resulting in cerebral palsy (CP). The purpose of this study is to determine the prevalence of CP in CHD in a single-center cohort, stratify risk based on surgical mortality using Society of Thoracic Surgeons-European Association for Cardio-Thoracic Surgery (STAT) categories and identify risk factors.
METHODS METHODS
Retrospective cohort study of pediatric patients registered in the University of Florida (UF) Society of Thoracic Surgeons Congenital Heart Surgery database from 2006 to 2017 with a diagnosis of CHD who continued follow-up for more than two years at UF.
RESULTS RESULTS
A total of 701 children with CHD met inclusion criteria. Children identified to have CP were 54 (7.7%). Most common presentation was spastic hemiplegic CP with a Gross Motor Function Classification System of level 2. Analysis of surgical and intensive care factors between the two groups showed that children with CHD and CP had longer time from admission to surgery (P = 0.003), higher STAT categories 4 and 5 (P = 0.038), and higher frequency of brain injury and seizures (P < 0.001). Developmental disabilities and rehabilitation needs were significantly greater for children with CHD and CP when compared with those with CHD alone (P < 0.001).
CONCLUSIONS CONCLUSIONS
In our cohort, 7.7% children with CHD develop CP; this is significantly higher than the 2010 US population estimate of 0.3%. Our study suggests higher STAT categories, brain injury, and seizures are associated with developing CP in children with CHD.

Identifiants

DOI: 10.1016/j.pediatrneurol.2024.02.011 PMID: 38640862
pubmed: 38640862
pii: S0887-8994(24)00061-4
doi: 10.1016/j.pediatrneurol.2024.02.011
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

133-140

Informations de copyright

Copyright © 2024 Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Auteurs

Suman Ghosh (S)

State University of New York at Downstate Health Sciences University, Brooklyn, New York; Department of Neurology, New York City Health and Hospitals Corporation Kings County Hospital, Brooklyn, New York. Electronic address: suman.ghosh@downstate.edu.

Ing Grace Lien (IG)

Department of Neurology, University of Florida, Gainesville, Florida.

Kerstin Martinez (K)

Herbert Wertheim College of Engineering, University of Florida, Gainesville, Florida.

Tracy Lin (T)

College of Liberal Arts and Sciences, University of Florida, Gainesville, Florida.

Mark S Bleiweis (MS)

University of Florida Health Congenital Heart Center, Gainesville, Florida.

Joseph Philip (J)

University of Florida Health Congenital Heart Center, Gainesville, Florida.

Lori C Jordan (LC)

Division of Pediatric Neurology, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee.

Steven G Pavlakis (SG)

State University of New York at Downstate Health Sciences University, Brooklyn, New York; Department of Neurology, New York City Health and Hospitals Corporation Kings County Hospital, Brooklyn, New York.

Classifications MeSH