Mortality due to cardiovascular disease, respiratory disease, and cancer in adults with cerebral palsy

Abstract

AimTo compare mortality rates for cardiovascular disease, cancer, and respiratory disease between adults with cerebral palsy (CP) and the general population.MethodA cohort study was conducted using data from adults with CP in England, identified through a primary care data set (the Clinical Practice Research Datalink), with linked data on death registrations from the Office for National Statistics. Cause of death was categorized according to International Classification of Diseases codes. Standardized mortality ratios (SMRs) were calculated to compare mortality rates between adults with CP and the general population, adjusted for age, sex, and calendar year.ResultsNine hundred and fifty‐eight adults with CP were identified (52.5% males, 47.5% females; median age at start of follow‐up 31y [interquartile range 22–43y]) and followed for a total of 7693 person‐years. One hundred and forty‐two patients (15%) died during follow‐up. Adults with CP had an increased risk of death due to cardiovascular disease (SMR: 3.19, 95% confidence interval [CI] 2.20–4.62) and respiratory disease (SMR: 13.59, 95% CI 9.89–18.67), but not from malignant neoplasms (SMR: 1.42, 95% CI 0.83–2.45).InterpretationWe found that adults with CP in England have increased risk of death due to diseases of the circulatory and respiratory systems, supporting findings from two studies that compared cause‐specific mortality rates between adults with CP in the USA and the general population. Further research is required into primary and secondary prevention of cardiovascular and respiratory disease in people with CP worldwide.What this paper adds Adults with cerebral palsy (CP) in England have 14‐fold increased risk of mortality due to diseases of the respiratory system.They have a 3‐fold increased risk of mortality due to diseases of the circulatory system.Adults with CP had an increased risk of death due to cerebrovascular disease and ischaemic heart disease.The elevated risk of ischaemic heart disease, however, did not reach statistical significance at the 5% per cent level.

Total and regional body fat status among children and young people with cerebral palsy: A scoping review

“…20,21 Indeed, adults with CP have a markedly higher prevalence of several obesity-related health problems compared to adults without CP, including musculoskeletal diseases, [22][23][24][25] cardiometabolic diseases, 22,24,26,27 mental health disorders 28,29 and cardiovascularrelated death. 30,31 Therefore, accurate assessment of body fat among individuals with CP during growth and development is clinically important, as it may inform preventive and rehabilitative strategies to maximize health and function as they age throughout their lifespan.…”

Mortality risk among adults with cerebral palsy: alarming findings and lingering questions

“…The paper by Ryan et al. helps reduce this gap in the literature for adults with CP . Results from their study confirm that adults with CP have high rates of death from respiratory disease and circulatory disease, although this does not constitute the real contribution of this study.…”

Is cerebral palsy a cause of death?

“…3 If the general principle does not apply, a number of selection rules are used to select the underlying cause of death. 2 For the purpose of this letter, we provide standardized mortality ratios (SMRs) for malignant neoplasms, diseases of the respiratory system, and diseases of the circulatory system, when the underlying cause of death is not reattributed to another cause (Table S1, online supporting information). The order in which causes of death are listed does not necessarily correspond to the order they are listed on the MCCD.…”