Abstract：
BACKGROUND: Children with congenital heart disease (CHD) have a higher prevalence of motor impairment secondary to brain injury, resulting in cerebral palsy (CP). The purpose of this study is to determine the prevalence of CP in CHD in a single-center cohort, stratify risk based on surgical mortality using Society of Thoracic Surgeons-European Association for Cardio-Thoracic Surgery (STAT) categories and identify risk factors.
METHODS: Retrospective cohort study of pediatric patients registered in the University of Florida (UF) Society of Thoracic Surgeons Congenital Heart Surgery database from 2006 to 2017 with a diagnosis of CHD who continued follow-up for more than two years at UF.
RESULTS: A total of 701 children with CHD met inclusion criteria. Children identified to have CP were 54 (7.7%). Most common presentation was spastic hemiplegic CP with a Gross Motor Function Classification System of level 2. Analysis of surgical and intensive care factors between the two groups showed that children with CHD and CP had longer time from admission to surgery (P = 0.003), higher STAT categories 4 and 5 (P = 0.038), and higher frequency of brain injury and seizures (P < 0.001). Developmental disabilities and rehabilitation needs were significantly greater for children with CHD and CP when compared with those with CHD alone (P < 0.001).
CONCLUSIONS: In our cohort, 7.7% children with CHD develop CP; this is significantly higher than the 2010 US population estimate of 0.3%. Our study suggests higher STAT categories, brain injury, and seizures are associated with developing CP in children with CHD.
METHODS: Retrospective cohort study of pediatric patients registered in the University of Florida (UF) Society of Thoracic Surgeons Congenital Heart Surgery database from 2006 to 2017 with a diagnosis of CHD who continued follow-up for more than two years at UF.
RESULTS: A total of 701 children with CHD met inclusion criteria. Children identified to have CP were 54 (7.7%). Most common presentation was spastic hemiplegic CP with a Gross Motor Function Classification System of level 2. Analysis of surgical and intensive care factors between the two groups showed that children with CHD and CP had longer time from admission to surgery (P = 0.003), higher STAT categories 4 and 5 (P = 0.038), and higher frequency of brain injury and seizures (P < 0.001). Developmental disabilities and rehabilitation needs were significantly greater for children with CHD and CP when compared with those with CHD alone (P < 0.001).
CONCLUSIONS: In our cohort, 7.7% children with CHD develop CP; this is significantly higher than the 2010 US population estimate of 0.3%. Our study suggests higher STAT categories, brain injury, and seizures are associated with developing CP in children with CHD.
摘要：
背景：先天性心脏病（CHD）儿童继发于脑损伤的运动障碍患病率较高，导致脑瘫（CP）。这项研究的目的是确定单中心队列中冠心病的患病率。使用胸外科医师协会-欧洲心胸外科协会(STAT)类别根据手术死亡率对风险进行分层,并确定风险因素.
方法：对2006年至2017年在佛罗里达大学（UF）胸外科医师学会先天性心脏手术数据库中注册的儿科患者进行回顾性队列研究，诊断为冠心病，并在UF继续随访超过两年。
结果：共有701名冠心病患儿符合纳入标准。确定患有CP的儿童为54（7.7％）。最常见的表现是具有2级粗大运动功能分类系统的痉挛性偏瘫性CP。两组间的手术和重症监护因素分析显示,CHD和CP患儿从入院到手术的时间较长(P=0.003)。较高的统计类别4和5(P=0.038)，脑损伤和癫痫发作的频率更高(P<0.001)。CHD和CP患儿的发育障碍和康复需求明显高于单纯CHD患儿（P<0.001）。
结论：在我们的队列中，7.7%的CHD儿童发展为CP;这显著高于2010年美国人口估计的0.3%。我们的研究表明，更高的统计类别，脑损伤,癫痫发作与CHD儿童的CP发展有关。
方法：对2006年至2017年在佛罗里达大学（UF）胸外科医师学会先天性心脏手术数据库中注册的儿科患者进行回顾性队列研究，诊断为冠心病，并在UF继续随访超过两年。
结果：共有701名冠心病患儿符合纳入标准。确定患有CP的儿童为54（7.7％）。最常见的表现是具有2级粗大运动功能分类系统的痉挛性偏瘫性CP。两组间的手术和重症监护因素分析显示,CHD和CP患儿从入院到手术的时间较长(P=0.003)。较高的统计类别4和5(P=0.038)，脑损伤和癫痫发作的频率更高(P<0.001)。CHD和CP患儿的发育障碍和康复需求明显高于单纯CHD患儿（P<0.001）。
结论：在我们的队列中，7.7%的CHD儿童发展为CP;这显著高于2010年美国人口估计的0.3%。我们的研究表明，更高的统计类别，脑损伤,癫痫发作与CHD儿童的CP发展有关。
