Abstract
BackgroundPneumonia is the leading cause of death among children and young people (CYP) with severe cerebral palsy (CP). Only a few studies used nomogram for assessing risk factors and the probability of pneumonia. Therefore, we aimed to identify risk factors and devise a nomogram for identifying the probability of severe pneumonia in CYP with severe CP.MethodsThis retrospective nationwide population-based cohort study examined CYP with newly diagnosed severe CP before 18 years old between January 1st, 1997 and December 31st, 2013 and followed them up through December 31st, 2013. The primary endpoint was defined as the occurrence of severe pneumonia with ≥ 5 days of hospitalization. Logistic regression analysis was used for determining demographic factors and comorbidities associated with severe pneumonia. These factors were assigned integer points to create a scoring system to identify children at high risk for severe pneumonia.ResultsAmong 6,356 CYP with newly diagnosed severe CP, 2,135 (33.59%) had severe pneumonia. Multivariable logistic regression analysis revealed that seven independent predictive factors, namely age <3 years, male sex, and comorbidities of pressure ulcer, gastroesophageal reflux, asthma, seizures, and perinatal complications. A nomogram was devised by employing these seven significant predictive factors. The prediction model presented favorable discrimination performance.ConclusionsThe nomogram revealed that age, male sex, history of pressure ulcer, gastroesophageal reflux, asthma, seizures, and perinatal complications were potential risk factors for severe pneumonia among CYP with severe CP.
Highlights
Cerebral palsy (CP), a crucial global public health concern, is the most common physical disability in early childhood [1,2,3]
The data underlying this study was obtained from the National Health Insurance Research database (NHIRD)
The nomogram revealed that age, male sex, history of pressure ulcer, gastroesophageal reflux, asthma, seizures, and perinatal complications were potential risk factors for severe pneumonia among children and young people (CYP) with severe cerebral palsy (CP)
Summary
Cerebral palsy (CP), a crucial global public health concern, is the most common physical disability in early childhood [1,2,3]. Children with CP are vulnerable to respiratory infection complications and have a higher risk of mortality [10, 11]. The primary reason for hospitalizations [12] and the leading cause of death among younger individuals with CP is pneumonia [4]. More than half (53%–58.6%) of the deaths among children with CP were attributed to respiratory infection and failure [13, 14]. Pneumonia is the leading cause of death among children and young people (CYP) with severe cerebral palsy (CP). A few studies used nomogram for assessing risk factors and the probability of pneumonia.
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