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Age‐related trends in cardiometabolic disease among adults with cerebral palsy
Author(s) -
Peterson Mark D,
Kamdar Neil,
Hurvitz Edward A
Publication year - 2019
Publication title -
developmental medicine and child neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.658
H-Index - 143
eISSN - 1469-8749
pISSN - 0012-1622
DOI - 10.1111/dmcn.13777
Subject(s) - hazard ratio , medicine , proportional hazards model , diabetes mellitus , pediatrics , cumulative incidence , demography , gerontology , confidence interval , endocrinology , cohort , sociology
Aim To examine the longitudinal trends of cardiometabolic diseases in a large sample of adults with cerebral palsy ( CP ). Method The Optum Clinformatics Data Mart is a de‐identified nationwide claims database of beneficiaries from a single private payer. Beneficiaries were included if they had an International Classification of Diseases, Ninth Revision, Clinical Modification code for a diagnosis of CP . Adults with at least 3 years of continuous enrollment on a single plan between 2002 and 2009 were included in the final analyses ( n =2659). We examined the longitudinal trends of incident diabetes mellitus, hypercholesterolemia, hypertension, cardiac dysrhythmias, and atherosclerosis, stratified by age categories: 18 to 39 years, 40 to 59 years, and 60 years and over. Kaplan–Meier product‐limit survival curves were compared across age categories for each of the cardiometabolic outcomes, and a Cox proportional hazards regression was run to determine adjusted hazard ratios. Results The cumulative incidence of each of the cardiometabolic diseases ranged from 6.0% for atherosclerosis to 34.4% for hypercholesterolemia at 3 years and over. Risk‐adjusted Cox proportional hazard models revealed that age was a robust predictor of survival for each outcome, with higher hazard ratio ranges in middle age (hazard ratio 1.41–2.72) and older adults (hazard ratio 2.20–5.93) compared with young adults. Interpretation Adults with CP have high rates of cardiometabolic diseases; and disease‐free survival shortens significantly with higher ages. What this paper adds Adults with cerebral palsy have high rates of cardiometabolic diseases. Disease‐free survival of all cardiometabolic diseases shortens significantly with higher ages. The highest rates were for hypercholesterolemia and hypertension.