Mortality in a Cohort of Children with Cerebral Palsy Enrolled in Hip Surveillance
Yang C, Juricic M, Mulpuri K, Schaeffer EK. Mortality in a Cohort of Children with Cerebral Palsy Enrolled in Hip Surveillance. Canadian Orthopaedic Association Meeting, Vancouver, BC, Canada. June 2025.
Abstract
Purpose:
Medical complexities and life expectancy may play a role in surgical decision making when considering reconstructive hip surgery. Mortality has been associated with surgical hip intervention but literature is limited. This study aimed to determine the number of children enrolled in the province’s hip surveillance program who have died and the proximity of death to orthopaedic hip intervention.
Method:
All children in British Columbia who were enrolled in the hip surveillance program from September 1, 2015 to December 31, 2023 and had died were included in the review. In this retrospective study, data related to diagnosis, co-morbidities, cause of death, orthopaedic radiographic measurements, and orthopaedic interventions were accessed from hospital records and the program’s database.
Results:
Fifty (3.3%) out of 1502 children enrolled in the hip surveillance program had died. Diagnoses of those deceased were: 35 cerebral palsy and 15 varying progressive conditions. Mobility was classified at or consistent with Gross Motor Function Classification levels as follows: II (2), III (1), IV (4), V (43). The mean age at time of death was 9.4 years (SD 4.6). Respiratory causes were most commonly identified as cause of death. In the past year, 76% of the deceased had been admitted to hospital with 76% had an admission for respiratory care. Seizures were uncontrolled in 48% and controlled in 34%. All except 5 (10%) were fed via a G or GJ-tube. Eighteen (36%) had undergone bony reconstructive hip surgery at a mean age of 7.1 years (SD 3.4) and were predominantly male (61%), all except 1 were GMFCS V. The mean time between surgery and death was 3.7 years (SD 2.5). Out of the 220 children that underwent hip reconstructive surgery in the program, 104 children were at GMFCS V. Four deaths occurred within 1 year of surgery at a mean age of 7.6 years all at GMFCS V, resulting in a 3.8% mortality rate within the first year.
Conclusion:
Surgical mortality following reconstructive hip surgery within the first year, was 3.8% for children at GMFCS level V.