A national perspective of surgery in children with cerebral palsy

Abstract

Purpose: Children with cerebral palsy (CP) often require surgery, but may be at higher risk for surgical complications and poorer outcomes than children without CP. This study provides a national perspective of the children, hospitals and hospital course associated with the five most commonly performed surgeries in children with CP and compares this perspective to that of children without CP undergoing the same procedures.

Methods: Analysis of the 1997 Healthcare Cost and Utilization Project Kids' Inpatient Database.

Results: The most common surgeries performed in children with CP (n = 37 000) were gastrostomy tube placements (n = 1743), soft tissue musculoskeletal procedures (n = 1393), fundoplications (n = 1062), spinal fusions with instrumentation (n = 765) and bony hip surgeries (n = 651). Together, the five procedures accounted for nearly 50 000 hospital days and over 150 million dollars in hospital charges in 1997. The largest difference in outcomes between children with and without CP was seen in those undergoing surgery for scoliosis.

Conclusions: Surgical procedures are frequent in children with CP. Their costs and impact on the US health care system are substantial. The findings provide a strong incentive to carefully study the benefits of the procedures and to develop interventions to improve outcomes, particularly in the case of scoliosis surgery.