Predicting functional outcomes following surgical intervention and inpatient rehabilitation stay in children with cerebral palsy.

Abstract

Background The ability to predict functional outcomes in children with cerebral palsy (CP) after surgical procedures and a subsequent inpatient rehabilitation unit (IRU) stay is limited based on current literature. Objective To determine if length of stay (LOS) and functional outcomes could be predicted in children with CP following a surgical procedure and IRU stay based on the surgical procedure performed, pattern of involvement, etiology, and Gross Motor Function Classification System level. Design Retrospective cohort study. Setting Tertiary care pediatrics. Participants Pediatric patients with CP (N = 139) who underwent one of three surgical procedures followed by an IRU stay. Interventions Selective dorsal rhizotomy, single-event multilevel orthopedic surgery, or intrathecal baclofen pump implantation and subsequent IRU stay. Main outcome measures IRU LOS, Functional Independence Measure for Children (WeeFIM) total score, subscores (mobility, self-care, and cognition), efficiency, and change score. Results Surgical procedure and WeeFIM mobility subscore at admission were significantly predictive of LOS (p Conclusions LOS and functional outcomes could be predicted with a minimal set of factors accounting for 86% of the variance. Cognition at IRU admission has an important influence on functional outcomes during the postoperative rehabilitation period.