Abstract：
BACKGROUND: While research has provided key insights into mortality rates and risks for individuals with cerebral palsy (CP), clinically useable mortality risk estimates remain unreported for adults with CP, especially by key patient-level factors.
OBJECTIVE: The objective of this study was to generate clinically useable mortality risk estimates among adults with CP to inform clinical decision making.
METHODS: This retrospective cohort study, using a fee-for-service Medicare database, identified adults ≥18-years-old with CP from 01/01/2008-12/31/2010 and followed through 12/31/2019 for death. Mortality risk at 1-, 3-, 5-, and 9-year intervals were selected based on common clinical length of time to reasonably benefit from preventive care. Sex-stratified analyses assessed risk estimates by narrow age group (18-25/26-34/35-44/45-54/55-64/65-74/≥75 years old) and multi-morbidity group (Whitney Comorbidity Index score 0-2/3/4-6/≥7).
RESULTS: Of 24,767 adults with CP, n = 12,962 were men (mean [SD] age = 48.3 [15.0] years) and n = 11,805 were women (age = 49.7 [15.8] years). Loss to follow-up was rare. 1-year risk was similar between men and women (3.4 % vs. 3.3 %), but increased slightly more for men than women through 9-years (30.1 % vs. 28.0 %). As expected, the mortality risk increased with older age and higher WCI scores. The probability of death (and survival) is presented per age and multi-morbidity group for men and women with CP.
CONCLUSIONS: Mortality risk estimates were reported at clinically relevant intervals by age, sex, and multi-morbidity status. This information can be used to weigh harm-to-benefit ratios of screening and treatment strategies based on mortality expectancy estimates.
OBJECTIVE: The objective of this study was to generate clinically useable mortality risk estimates among adults with CP to inform clinical decision making.
METHODS: This retrospective cohort study, using a fee-for-service Medicare database, identified adults ≥18-years-old with CP from 01/01/2008-12/31/2010 and followed through 12/31/2019 for death. Mortality risk at 1-, 3-, 5-, and 9-year intervals were selected based on common clinical length of time to reasonably benefit from preventive care. Sex-stratified analyses assessed risk estimates by narrow age group (18-25/26-34/35-44/45-54/55-64/65-74/≥75 years old) and multi-morbidity group (Whitney Comorbidity Index score 0-2/3/4-6/≥7).
RESULTS: Of 24,767 adults with CP, n = 12,962 were men (mean [SD] age = 48.3 [15.0] years) and n = 11,805 were women (age = 49.7 [15.8] years). Loss to follow-up was rare. 1-year risk was similar between men and women (3.4 % vs. 3.3 %), but increased slightly more for men than women through 9-years (30.1 % vs. 28.0 %). As expected, the mortality risk increased with older age and higher WCI scores. The probability of death (and survival) is presented per age and multi-morbidity group for men and women with CP.
CONCLUSIONS: Mortality risk estimates were reported at clinically relevant intervals by age, sex, and multi-morbidity status. This information can be used to weigh harm-to-benefit ratios of screening and treatment strategies based on mortality expectancy estimates.
摘要：
背景：虽然研究为脑瘫（CP）患者的死亡率和风险提供了关键见解，对于患有CP的成年人，临床可用的死亡率风险估计值仍未报告，尤其是患者层面的关键因素。
目的：本研究的目的是在CP患者中生成临床可用的死亡风险估计值，以指导临床决策。
方法：这项回顾性队列研究，使用按服务收费的Medicare数据库，从2008年1月1日至2010年12月31日确定≥18岁的成年人患有CP，并随访至2019年12月31日死亡。1-的死亡风险，3-,5-,和9年的间隔是根据常见的临床时间长度选择的,以合理地从预防性护理中获益.性别分层分析按狭窄年龄组（18-25/26-34/35-44/45-54/55-64/65-74/≥75岁）和多发病率组（惠特尼合并症指数评分0-2/3/4-6/≥7）评估风险估计。
结果：在24,767名患有CP的成年人中，n=12,962为男性（平均[SD]年龄=48.3[15.0]岁），n=11,805为女性（年龄=49.7[15.8]岁）。随访损失很少。男性和女性的1年风险相似(3.4%vs.3.3%），但在9岁期间，男性的增幅略高于女性(30.1%vs.28.0%）。不出所料,死亡风险随着年龄的增长和WCI评分的提高而增加.对于患有CP的男性和女性，按年龄和多发病率组列出了死亡（和生存）的可能性。
结论：按年龄在临床相关间隔报告死亡率风险估计值，性别,和多发病状态。该信息可用于根据预期死亡率估计来衡量筛查和治疗策略的利弊比。
目的：本研究的目的是在CP患者中生成临床可用的死亡风险估计值，以指导临床决策。
方法：这项回顾性队列研究，使用按服务收费的Medicare数据库，从2008年1月1日至2010年12月31日确定≥18岁的成年人患有CP，并随访至2019年12月31日死亡。1-的死亡风险，3-,5-,和9年的间隔是根据常见的临床时间长度选择的,以合理地从预防性护理中获益.性别分层分析按狭窄年龄组（18-25/26-34/35-44/45-54/55-64/65-74/≥75岁）和多发病率组（惠特尼合并症指数评分0-2/3/4-6/≥7）评估风险估计。
结果：在24,767名患有CP的成年人中，n=12,962为男性（平均[SD]年龄=48.3[15.0]岁），n=11,805为女性（年龄=49.7[15.8]岁）。随访损失很少。男性和女性的1年风险相似(3.4%vs.3.3%），但在9岁期间，男性的增幅略高于女性(30.1%vs.28.0%）。不出所料,死亡风险随着年龄的增长和WCI评分的提高而增加.对于患有CP的男性和女性，按年龄和多发病率组列出了死亡（和生存）的可能性。
结论：按年龄在临床相关间隔报告死亡率风险估计值，性别,和多发病状态。该信息可用于根据预期死亡率估计来衡量筛查和治疗策略的利弊比。
