title: Survival and functional outcome of children with severe cerebral palsy following gastrostomy.
abstract: 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.
authors.affiliation: Medical College of Wisconsin, Milwaukee.
authors.forename: S J
authors.initials: SJ
authors.lastname: McGrath
authors.forename: M L
authors.initials: ML
authors.lastname: Splaingard
authors.forename: H M
authors.initials: HM
authors.lastname: Alba
authors.forename: B H
authors.initials: BH
authors.lastname: Kaufman
authors.forename: M
authors.initials: M
authors.lastname: Glicklick
mesh_terms: 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