Impaired mobility associated with an increased likelihood of death in children: A systematic review
Title
Impaired mobility associated with an increased likelihood of death in children: A systematic review
Creator
Nissen S; Purssell E; Shaw K; Bailey C; Efstathiou N; Dunford C
Identifier
Publisher
Journal of child health care : for professionals working with children in the hospital and community
Date
2018
Subject
Embase; palliative therapy; risk factor; systematic review; human; article; child; female; male; Medline; death; high income country; child health; Gross Motor Function Classification System; immobility; Cochrane Library; handicapped child; SciSearch
Description
Improved identification of children with an increased likelihood of death can support appropriate provision of integrated palliative care. This systematic review aims to consider immobility and the associated likelihood of death in children with disabilities, living in high-income countries. Two reviewers independently searched MEDLINE, Embase, Cochrane Library, OpenGrey and Science Citation Index (1990-2016) for studies that reported hazard ratios (HRs) and relative risk for the likelihood of death related to impaired mobility. Nine papers were included. Three studies reported functioning using the Gross Motor Function Classification Scale (GMFCS) and the remaining studies reported measures of functioning unique to the study. The strongest single prognostic factor for the likelihood of death was 'lack of sitting ability at 24 months', HR 44.4 (confidence interval (CI) 6.1-320.8) followed by GMFCS V HR 16.3 (CI 5.6-47.2) and 11.4 (CI 3.76-35.57) and 'not able to cruise by 24 months', HR 14.4 (CI 3.5-59.2). Immobility is associated with an increased risk of dying over study periods, but different referent groups make clinical interpretation challenging. Overall, the quality of evidence is moderate. The findings suggest that immobility can support identification of children who may benefit from integrated palliative care.
Citation List Month
January 2019 List
URL Address
Collection
Citation
Nissen S; Purssell E; Shaw K; Bailey C; Efstathiou N; Dunford C, “Impaired mobility associated with an increased likelihood of death in children: A systematic review,” Pediatric Palliative Care Library, accessed April 27, 2024, https://pedpalascnetlibrary.omeka.net/items/show/15909.