Survival and functional outcome of children with severe cerebral palsy following gastrostomy.
Survival, functional outcome, care setting, early and late complications, and caregiver satisfaction were determined in 61 children with severe cerebral palsy requiring gastrostomies during a six-year period. Fifty-three (87%) of the initial gastrostomies included a Nissen fundoplication. Early and late complications were 32.8% and 39.3%, respectively. Survival after initial surgery was 84.2% at one year, and 67.6% at four years. One child died within one month of surgery. Seventy percent of the children remained totally dependent in self-care, mobility, and communication; an additional 29% had significant limitations in function. Only 4 children (6.5%) ultimately became independent in feeding. Ninety-three percent of the children were cared for at home. Ninety-four percent of the parents/caregivers believed the gastrostomy was beneficial in management of the child. Survival was unexpectedly high compared to studies of adults and mentally retarded children requiring similar surgical procedures.
McGrath
S J
SJ
Medical College of Wisconsin, Milwaukee.
Splaingard
M L
ML
Alba
H M
HM
Kaufman
B H
BH
Glicklick
M
M
D000203:Activities of Daily Living; D000293:Adolescent; D002547:Cerebral Palsy / Q000534:rehabilitation*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005774:Gastrostomy / Q000009:adverse effects / Q000401:mortality / Q000534:rehabilitation*; D006801:Humans; D007223:Infant; D015993:Life Tables; D008297:Male; D012086:Reoperation; D016019:Survival Analysis; D016896:Treatment Outcome