Profile of hospital admissions for adults with cerebral palsy: a retrospective cohort study

Abstract

Aim To retrospectively profile acute hospital admissions for a defined cohort of adults with cerebral palsy (CP). Method Five years of health service data were interrogated to identify acute health service use by adults with CP. Admission types were described, admission reasons categorized using International Classification of Diseases, 10th Revision codes, and length of stay (LOS) calculated. Any differences between paediatric and adult subsets were explored. Results Individuals with CP constituted 2922 admissions. Of these, 850 (29%) were adult admissions. There were significant differences between admission reasons for paediatric and adult cohorts, with adults predominantly seeking hospital admission for emergency rather than planned care (emergency reason: adults 62.1%, paediatrics 25.2%; p<0.001). The median adult admission LOS was longer than that of children (p<0.001). The primary diagnosis admission reason in the adult data set was respiratory illness (20%) followed closely by gastrostomy dysfunction (19%). Interpretation Adults with CP predominantly access acute hospital services for emergency health care. A high frequency of admissions is associated with respiratory illness and gastrostomy dysfunction in adults with CP. Adults with cerebral palsy (CP) access acute inpatient services for emergency health care. Hospital admissions are predominantly because of respiratory illness and gastrostomy dysfunction. Admission length of stay is longer for adults than children. Many adults with CP require hospitalization more than once a year.

Emergency department usage by adults with cerebral palsy: A retrospective cohort study

“…The high rate of respiratory presentations is consistent with previous literature on respiratory risk factors in those with CP, alongside published studies on inpatient hospital admissions in this cohort 12,18,22 . Study results also showed an increase in rates of pneumonia between paediatric and adult cohorts.…”

“…The high rates of age‐related comorbidities and health exacerbations in those with CP could contribute to the high hospital admission rate seen in the adult subgroup (71%) 3 . This positive age‐related trend is consistent with previous analysis of inpatient admissions of adults with CP at Monash Health 18 . A similar trend is seen in the general population, and in international studies on people with CP 5,12,22 .…”

“…Participant demographics were captured and ED presentation frequency extracted 18 . A breakdown of residential area (metropolitan/non‐metropolitan) was calculated 19,20 .…”

“…Participant demographics were captured and ED presentation frequency extracted. 18 A breakdown of residential area (metropolitan/nonmetropolitan) was calculated. 19,20 Socioeconomic status was derived via a proxy (index of relative socioeconomic disadvantage) and described in quintiles.…”

Understanding the prevalence of psychiatric disorders in people with cerebral palsy: A systematic review protocol

“…Regardless the general consensus stands that people with CP have worse physical health than the general population. For example, people with CP are at increased risk of developing diabetes, heart disease, and stroke (Peterson et al, 2015), and have higher rates of hospital admissions and access acute inpatient services for emergency health care more than people without CP (Morgan et al, 2020). People with CP have an increased risk of early mortality due to ischaemic heart disease, cerebrovascular disease, respiratory diseases, and circulatory disorders (Ryan et al, 2019).…”