Original article
Reasons for Hospital Admissions Among Youth and Young Adults With Cerebral Palsy

https://doi.org/10.1016/j.apmr.2010.10.002Get rights and content

Abstract

Young NL, McCormick AM, Gilbert T, Ayling-Campos A, Burke T, Fehlings D, Wedge J. Reasons for hospital admissions among youth and young adults with cerebral palsy.

Objective

To identify the most common reasons for acute care hospital admissions among youth (age range, 13–17.9y) and young adults (age range, 23–32.9y) with cerebral palsy (CP).

Design

We completed a secondary analysis of data from the Canadian Institute for Health Information (CIHI) to determine the most frequently observed reasons for admissions and the associated lengths of stay (LOS).

Setting

Participants were identified from 6 children's treatment centers in Ontario, Canada.

Participants

Health records data from youth with CP (n=587) and young adults with CP (n=477) contributed to this study.

Interventions

Not applicable.

Main Outcome Measures

The most common reasons for hospital admission, relative frequencies of admissions for each reason, and mean LOS were reported.

Results

The analysis of CIHI records identified epilepsy and pneumonia as the top 2 reasons for admissions in both age groups. Both age groups were commonly admitted because of infections other than pneumonia and urinary tract infections (UTIs), gastrointestinal (GI) problems such as malabsorption, and mental illness. The reasons that were unique to youth included orthopedic and joint-related issues, other respiratory problems, and scoliosis. In young adults, mental illness was the third most common reason for admission, followed by lower GI or constipation problems, malnutrition or dehydration, upper GI problems, fractures, and UTIs.

Conclusions

This article provides important clinical information that can be used in the training of physicians and health care providers, and to guide future planning of ambulatory care services to support the clinical management of persons with CP over their lifespan.

Section snippets

Methods

We sought to objectively identify the most common reasons for admissions and associated LOS, based on a secondary analysis of health care services delivery data. Canada provides an ideal context to study the reasons for admissions because universal access to physician services is provided to all citizens through a federally funded health care insurance system. All admissions to acute care hospitals across Canada (with the exception of Quebec) are captured in the CIHI database. This database

Results

CIHI data from a sample of 1064 youth and young adults with CP were analyzed. The mean age ± SD of the youth group was 15.4±1.46 years, and 43.6% were girls. The mean age ± SD of the adult group was 26.3±2.6 years, and 42.3% were women. During the 4-year period studied, 32.2% of youth and 19.3% of young adults were admitted to an acute care hospital at least once. The total number of admissions studied was 609. The annual rates of admission were 180 per 1000 for youth and 98 per 1000 for young

Discussion

This article provides an understanding of the most common reasons for hospital admission, among youth and young adults with CP, based on empirical evidence. This health services analysis also provides statistical estimates of the rates of admissions and LOS for each of these reasons based on a large sample.

The predominant clinical issues leading to admission in both youth and young adults were epilepsy and pneumonia, accounting for 25.4% of admissions among the youth and 23.0% among the young

Conclusions

It is clear that individuals with childhood CP are frequently admitted to the hospital. It behooves clinicians to be aware of the common reasons for admissions and strategize to develop preventive care. Understanding the reasons for these admissions to the hospital and the LOS is an important cornerstone for primary health care providers to facilitate maintenance of health. This is the first article to provide a comprehensive description of the reasons for hospital admissions among youth and

Acknowledgments

We thank the Transition Study Team who supported the initial project from which the present study was generated.

References (22)

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    Supported by an operating grant from the Canadian Institutes of Health Research (CIHR; grant no. MOP-64460). Dr Young is the beneficiary of a salary support award from CIHR (grant no. 950-202686).

    No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.

    Reprints are not available from the author.

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