Mortality Rate in Institutionalized Mentally Retarded Children

Roboz, Paul

doi:10.5694/j.1326-5377.1972.tb46767.x

Cited by 21 publications

(7 citation statements)

References 5 publications

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“…As with previous studies, we found a strong association between the severity of impairments and a higher risk of early mortality. With an adjusted hazard ratio of 6.2, lack of independent ambulation was the strongest independent predictor of mortality, an association that was first recognized in an Australian study in 1972 20 . Other factors that were independently associated with mortality in this cohort were severe/profound intellectual impairment, bilateral deafness, and epilepsy.…”

Section: Discussionsupporting

confidence: 51%

Survival of individuals with cerebral palsy born in Victoria, Australia, between 1970 and 2004

Reid

Carlin

Reddihough

2012

Develop Med Child Neuro

139

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AIM This study used data collected prospectively since 1986 from a population-based cerebral palsy registry to explore the rates, predictors, trends, and causes of mortality for individuals born in Victoria, Australia, between 1970 and 2004. METHOD Data were extracted for 3507 individuals (1972 males; 1535 females). The probability of survival before 31 May 2010 was determined using the Kaplan-Meier method; age-specific mortality rates were calculated per 1000 person-years and related to population rates. Using Cox proportional hazards regression, relative risks of mortality were estimated for different categories of chosen demographic and clinical variables. Causes were tabulated according to the direct cause of death.RESULTS There were 418 deaths. Crude mortality was 20% at the age of 40 years. Relative to the population, mortality was highest in children aged under 15 years and decreased to twice the population rate at the age of 35 years. The strongest independent predictor of mortality was no independent ambulation (adjusted hazard ratio 6.2 [95% confidence interval 3.3-11.8]); additional predictors were severe intellectual impairment Cerebral palsy (CP) is a diagnostic label that embraces a range of disorders of movement and posture. Substantial variation exists with regard to the type, topographical pattern, and severity of the movement disorder, the presence of associated conditions and impairments, and how these combine to impact on function, participation, and quality of life. Since the label 'CP' accommodates such a wide variety of possible clinical manifestations, information about survival with CP based on different combinations of clinical features is needed to counsel families about a child's prognosis, to plan for the provision of medical, educational, and social services, to inform public policy, and for medicolegal services relating to litigation. The aim of this study was to describe the rates, trends, predictors, and causes of mortality in individuals with nonpostneonatally acquired CP who were born in the Australian state of Victoria between 1970 and 2004. A number of groups have previously studied life expectancy in CP samples but many studies have had shortcomings. Recent studies of all CP cases from long-standing registers in Western Australia, 1 the UK, 2 and Denmark 3 have provided useful information on the long-term prognosis of all newly diagnosed children. The UK study noted regional differences in survival, but it was unclear whether these reflected regional variation in survival patterns, risk factor profiles, levels of care, or differences in definition, classification, or ascertainment.2 Severity of disability is the key factor influencing survival in CP. Immobility or severe motor impairment of all four limbs, 1-9 intellectual impairment, 1,2,4-7,10 epilepsy, 3,4,10 severe visual and hearing impairments, 2,7,11 hydrocephalus, 4 and an increasing number of impairments 1,2,5-7 have been associated with poorer survival. Although different severity profiles have been used by ea...

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Section: Discussionsupporting

confidence: 51%

Survival of individuals with cerebral palsy born in Victoria, Australia, between 1970 and 2004

Reid

Carlin

Reddihough

2012

Develop Med Child Neuro

139

View full text Add to dashboard Cite

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“…1998; Patja et al. 2001), may be even more prevalent in people with reduced mobility (Roboz 1972; Eyman et al. 1987).…”

Section: Discussionmentioning

confidence: 99%

“…It is not the intention of this study to investigate the causes of death. However, it has been suggested that the risk of infections, already contributing to excess deaths in the intellectual disability population (Hollins et al 1998;Patja et al 2001), may be even more prevalent in people with reduced mobility (Roboz 1972;Eyman et al 1987).…”

Section: Discussionmentioning

confidence: 99%

The Impact of Physical, Intellectual and Social Impairments on Survival in Adults with Intellectual Disability: A Population‐Based Register Study

Tyrer

Smith

McGrother

et al. 2007

Research Intellect Disabil

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Background Research into factors associated with survival in adults with intellectual disability is limited and no studies have controlled for changes in these factors over time.Material and Methods All adults aged ‡20 years with moderate to profound intellectual disability (approximate IQ < 50) using specialist services in Leicestershire and Rutland, UK, were identified. The relationship between survival and physical, intellectual and social impairments was investigated, also adjusting for age, sex, ethnicity and exact year of birth. Results Of 2453 adults studied, 402 (16%) died over a maximum follow-up period of 19 years. While physical, intellectual and social impairments were all associated with survival individually, physical impairment was the only impairment to significantly predict survival in the multi-variable analysis. Being non-mobile was associated with a sevenfold increased risk of death and being partially mobile with a twofold increased risk of death compared with being fully mobile [adjusted hazards ratios (HR) ¼ 7.14; 95% confidence interval (CI) 4.99-10.21 and HR ¼ 2.33; 95% CI 1.84-2.95]. Being male and earlier year of birth were also associated with shorter survival. Conclusions The implications of these findings are discussed.

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“…Another intriguing finding was that children not affected by CP had an increased risk for infection pain. This is surprising, because it is known that restricted mobility is associated with reduced pulmonary ventilation and a higher incidence of respiratory infection (Roboz 1972). However, the finding that children who see a medical professional less often also had increased pain risk suggests that CP might be protective because it leads to more regular medical contact, increasing the likelihood of detection and intervention before infection causes pain to occur.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for pain in children with severe cognitive impairments

Breau

Camfield

McGrath

et al. 2004

Develop Med Child Neuro

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Diagnosing cause of pain in children with severe cognitive impairments is difficult due to their problems with communication. Identification of risk factors for specific pain etiologies might help professionals in this task. The aim of this study was to determine whether child-related characteristics increase risk for specific types of pain. Participants were the caregivers of 41 females and 53 males with moderate to profound mental retardation, who were aged 3 to 18 years 8 months (mean 10:1, SD 4:4) but who communicated at the level of a typical child of 13.8 months (SD 10 months): 44 of the children had cerebral palsy (CP) and 59 a seizure disorder. Caregivers reported the cause of children's episodes of pain for four 1-week periods over 1 year. Logistic regression analyses were used to predict occurrence of specific types of pain using children's demographic, medical, and physical characteristics. Children had 406 episodes of pain due to accident, gastrointestinal conditions, musculoskeletal problems, infection, recurrent conditions, and common childhood causes. Results indicated that a unique set of risk factors predicted each pain type in this sample. Significant risk factors for pain included: lack of visual impairment and leg impairment (accidental pain); seizures, leg impairment, and greater number of medications (non-accidental pain); being male and tube fed (musculoskeletal pain); age <7 years, absence of CP, visual impairment, and less frequent medical monitoring (infection pain); being female and with arm impairment (gastrointestinal pain); and being tube fed and taking fewer medications (common childhood pains). In most cases, models were more specific than sensitive, indicating that the significant predictors are more useful for eliminating potential pain causes. These results suggest that population risk factors may be helpful in structuring diagnostic investigations for individual children with severe cognitive impairments.

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Mortality Rate in Institutionalized Mentally Retarded Children

Cited by 21 publications

References 5 publications

Survival of individuals with cerebral palsy born in Victoria, Australia, between 1970 and 2004

Survival of individuals with cerebral palsy born in Victoria, Australia, between 1970 and 2004

The Impact of Physical, Intellectual and Social Impairments on Survival in Adults with Intellectual Disability: A Population‐Based Register Study

Risk factors for pain in children with severe cognitive impairments

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